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A Critique of Literature Using Acupuncture to Treat Lower Back Pain

by Dr (TCM) Attilio D'Alberto



Background: Lower back pain (LBP) is a major cause of suffering amongst the population of the UK and other nations. Acupuncture is now practiced by allopathic medical doctors as well as Chinese medicine practitioners. It is important to establish acupuncture efficacy in the treatment of LBP.
Objectives: To determine if acupuncture is an effective form of treatment for lower back pain (LBP).
Search Strategy: A literature search was carried out using Medline (1974-1996) and AMED. In addition ‘hand searching’, manual methods were employed at the British library.
Selection Criteria: All rigorous research, ranging from randomised controlled trials (RCTs) to case studies that reported the use of acupuncture in the treatment of lower back pain were included in the selection criteria. Studies that deviated from lower back pain to other affected areas of the body or used moxibustion, TENS or shallow needling were rejected. Six studies, three RCTs and three case studies, were randomly selected from papers collected and were included in this review.
Data Collection and Analysis: Three reviewers; Attilio D'Alberto BSc (Hons) TCM, Eunkyung Kim BA, BSc (Hons) TCM and Angelo D’Alberto BSc (Hons) TCM, independently assessed the randomised controlled trials (RCTs) according to the adapted Koes strategy. Case studies were critiqued as a group.
Results: Six papers were included, three RCTs and three case studies. One RCT scored more than 50 points, indicating a relatively average methodology, whilst the other two RCTs scored less than average. The three case studies were all published in traditional Chinese medical journals. Two studies reported the successful use of acupuncture as an intervention to treat lower back pain, whilst one reported an inconclusive outcome.
Reviewer’s Conclusions: The evidence summarised in this review does not support the use of acupuncture as an effective form of treatment for lower back pain. By comparing the ‘lesser’ forms of rigorous research (case studies), it could be demonstrated the RCTs had flaws which otherwise would not have been made available if RCTs were reviewed alone.
Keywords: acupuncture, lower, back, pain, lumbago.