Traditional versus sham acupuncture 18-2

 Traditional versus sham acupuncture for chronic low back pain: A systematic review

Sompolinsky Efrat, Springer Shmuel

 Abstract

Background: Acupuncture, an ancient Chinese practice for treating various pathologies, is at the core of the debate regarding the status of alternative medicine. More specifically, acupuncture is a popular alternative treatment for chronic low back pain (CLBP).

Objective: To compare the efficacy of acupuncture and sham acupuncture for treating patients with non-specific CLBP.

Method: An online search of PubMed and CINAHL, databases was performed. Included were randomized controlled trials that compared the efficacy of acupuncture versus sham acupuncture, published in the last decade, and written in English.

Results: Our search identified 64 randomized controlled trials, six of which met our inclusion criterion. Two different methods of sham acupuncture were identified: minimal acupuncture, superficial needling at non-classic (off the meridians) points (2 trials); and placebo acupuncture, non-penetrating needling using blunt needles (4 trials). No significant differences were found between the efficacy of acupuncture and minimal acupuncture. Acupuncture was found to be superior to placebo acupuncture, according to most trials 

Conclusion: The present review indicated that acupuncture and minimal acupuncture are equally efficient for treating CLBP. A possible explanation is the activation of pain modulation mechanisms resulting from the needling. In addition, non-specific effects, such as the relaxing nature of the acupuncture treatment, may be related to its efficacy and benefits. Thus, the findings appear to support the use of acupuncture as a treatment for CLBP; however, they lead us to question the need for full traditional acupuncture training. 

 Key words: low back pain, acupuncture, sham