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Low Back Pain
Ann Intern Med. 2005 Apr 19;142(8):651-63.
Meta-analysis: acupuncture for low back pain.
Manheimer E, White A, Berman B, Forys K, Ernst E.
University of Maryland School of Medicine, Center for Integrative
Medicine, Baltimore, Maryland 21207, USA.
BACKGROUND: Low back pain limits activity and is the second most
frequent reason for physician visits. Previous research shows widespread use of
acupuncture for low back pain.
PURPOSE: To assess acupuncture's effectiveness
for treating low back pain.
DATA SOURCES: Randomized, controlled trials were
identified through searches of MEDLINE, Cochrane Central, EMBASE, AMED, CINAHL,
CISCOM, and GERA databases through August 2004. Additional data sources
included previous reviews and personal contacts with colleagues.
STUDY
SELECTION: Randomized, controlled trials comparing needle acupuncture with sham
acupuncture, other sham treatments, no additional treatment, or another active
treatment for patients with low back pain.
DATA EXTRACTION: Data were dually
extracted for the outcomes of pain, functional status, overall improvement,
return to work, and analgesic consumption. In addition, study quality was
assessed.
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DATA SYNTHESIS: The 33 randomized, controlled trials that met
inclusion criteria were subgrouped according to acute or chronic pain, style of
acupuncture, and type of control group used. The principle measure of effect
size was the standardized mean difference, since the trials assessed the same
outcome but measured it in various ways. For the primary outcome of short-term
relief of chronic pain, the meta-analyses showed that acupuncture is
significantly more effective than sham treatment (standardized mean difference,
0.54 [95% CI, 0.35 to 0.73]; 7 trials) and no additional treatment
(standardized mean difference, 0.69 [CI, 0.40 to 0.98]; 8 trials). For patients
with acute low back pain, data are sparse and inconclusive. Data are also
insufficient for drawing conclusions about acupuncture's short-term
effectiveness compared with most other therapies.
LIMITATIONS: The quantity and
quality of the included trials varied.
CONCLUSIONS: Acupuncture effectively
relieves chronic low back pain. No evidence suggests that acupuncture is more
effective than other active therapies.
Publication Types:
PMID: 15838072 [PubMed - indexed for MEDLINE]
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