Skip to main content
. 2020 Mar;66(3):186–187.

Table 1.

Summary of the evidence for acupuncture for low back pain

STUDY TYPE POPULATION OUTCOMES*
Systematic review and meta-analysis1 (31 RCTs)

  • N = 6656

  • Age 17–90 y

  • 40% male, 60% female

  • Excluded LBP caused by trauma, infection, fracture, tumour, fibromyalgia, cauda equina syndrome

  • Acupuncture clinically superior to sham acupuncture in immediate pain reduction for chronic LBP (SMD = −0.49, 95% CI −0.76 to −0.21)

  • Acupuncture clinically superior to sham acupuncture 3 mo following treatment for chronic LBP (SMD = −0.45, 95% CI −0.76 to −0.14)

  • Acupuncture clinically superior compared with no treatment for chronic LBP (SMD = −0.73, 95% CI −0.96 to −0.49)

  • Acupuncture clinically superior compared with usual care in immediate pain reduction for chronic LBP (MD = −11.47, 95% CI −19.33 to −3.61, I2 = 59.9%)
Appraisal of systematic reviews2 (16 systematic reviews of RCTs)

  • N = 11 682

  • Age > 18 y

  • Acupuncture statistically but not clinically superior to sham acupuncture or usual care in immediate pain reduction for acute LBP (MD = −9.38, 95% CI −17.00 to −1.76, P = .02, I2 = 27%)

  • Acupuncture clinically superior to sham acupuncture or usual care in immediate pain reduction for chronic LBP (WMD = −5.88, 95% CI −11.20 to −0.55, at 1 mo; and WMD = −17.79, 95% CI −25.50 to −10.0, at 3 mo)
Systematic review3 (17 RCTs)

  • N = 7958

  • Age > 18 y

  • Excluded LBP related to cancer, infection, inflammatory arthropathy, trauma, fracture, pregnancy, neurologic deficits

  • Included radicular and nonradicular pain

  • Acupuncture statistically superior to sham acupuncture in immediate pain reduction for chronic LBP (WMD = −16.76, 95% CI −33.3 to −0.19)

  • Acupuncture statistically superior to sham acupuncture 3 mo following treatment for chronic low back (WMD = −9.55, 95% CI −16.5 to −2.58)

  • Acupuncture statistically superior compared with medications for chronic LBP (WMD = −10.56 on 0- to 100-point scale, 95% CI −20.34 to −0.78) and improved function (3 trials, SMD = −0.36, 95% CI −0.67 to −0.04)

  • Seven RCTs studying immediate effects on pain reduction (4 trials, SMD = −0.72, 95% CI −0.94 to −0.49) and function (3 trials, SMD = −0.94, 95% CI −1.41 to −0.47) favoured acupuncture over control with no acupuncture

LBP—low back pain, MD—mean difference, RCT—randomized controlled trial, SMD—standardized mean difference, WMD—weighed mean difference.

*

Cohen’s 3 levels of rating of clinical importance4: Small is a WMD < 10% of the scale, an SMD or d score < 0.5, or a relative risk of < 1.25 or > 0.8 (depending on whether the report referred to risk of benefit or the risk of harm); medium is a WMD from 10%–20% of the scale, an SMD or d score from 0.5–0.8; or a relative risk between 1.25 and 2.0 or between 0.5 and 0.8; and large is a WMD > 20% of the scale, an SMD or d score > 0.8, or a relative risk > 2.0 or < 0.5.