Standard and enhanced acupuncture treatments may not improve disability in adults with chronic low back pain

1. In older adults with chronic low back pain (CLBP), both standard and enhanced acupuncture treatments significantly improved disability compared to usual medical care, with benefits persisting up to 12 months. 

Evidence Rating Level: 1 (Excellent) 

Chronic low back pain (CLBP) is the leading cause of disability worldwide, particularly affecting older adults. Traditional treatments such as medications and invasive procedures offer limited benefit and pose a higher risk due to age-related changes and polypharmacy concerns. Acupuncture is a low-risk, effective and guideline-recommended treatment for CLBP; however, there has been a lack of large-scale clinical trials. To address this gap, this randomized clinical trial compared the use of usual medical care (UMC) alone with two acupuncture approaches in adults 65 years and older. 800 participants (mean [SD] age, 73.6 [6.0] years, 62.0% female) were randomized into these three groups in a 1:1:1 ratio. At 6 months, both the standard acupuncture (SA) and SA plus maintenance (enhanced acupuncture [EA]) groups showed significantly improved RMDQ scores compared with the UMC group (SA vs UMC: AMD, −1.0 [95% CI, −1.9 to −0.1] and SMD, −0.21; EA vs UMC: AMD, −1.5 [95% CI, −2.5 to −0.6] and SMD, −0.32). There was no significant difference between the acupuncture groups. EA showed a greater reduction in pain intensity than SA at 6 months, and both were significantly more effective than UMC. Overall, acupuncture use led to significant improvements in CLBP at 6- and 12-month follow-up compared to UMC alone in this group of older adults. 

Click to read this study in JAMA Network Open

Image: PD

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