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Trigger point acupuncture treatment of chronic low back pain in elderly patients -- a blinded RCT [with consumer summary] |
Itoh K, Katsumi Y, Kitakoji H |
Acupuncture in Medicine 2004;22(4):170-177 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: There is some evidence for the efficacy of acupuncture in chronic low back pain, but it remains unclear which acupuncture modes are most effective. Our objective was to evaluate the effects of two different modes of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared to standard acupuncture treatment. METHODS: Thirty five consecutive out-patients (25 women, 10 men; age range 65 to 81 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to one of three groups over 12 weeks. Each group received two phases of acupuncture treatment with an interval between them. Nine patients dropped out during the course of the study. The standard acupuncture group (n = 9) received treatment at traditional acupuncture points for low back pain, while the other acupuncture groups received superficial (n = 9) or deep (n = 9) treatments on trigger points. Outcome measures were VAS pain intensity and Roland Morris Questionnaire. RESULTS: After treatment, the group that received deep needling to trigger points reported less pain intensity and improved quality of life compared to the standard acupuncture group or the group that received superficial needling to trigger points, but the differences were not statistically significant. There was a significant reduction in pain intensity between the treatment and interval in the group that received deep needling to trigger points (p < 0.01), but not in the standard acupuncture group or the group that received superficial needling to trigger points. CONCLUSION: These results suggest that deep needling to trigger points may be more effective in the treatment of low back pain in elderly patients than either standard acupuncture therapy, or superficial needling to trigger points.
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