Effectiveness of Acupuncture for Low Back Pain: A Systematic Review

Jing Yuan, PhD; Nithima Purepong, MSc; Daniel Paul Kerr, PhD; Jongbae Park, KMD, PhD; Ian Bradbury, PhD; Suzanne McDonough, PhD


Spine. 2008;33(23):E887-E900. 

In This Article


Based on the results of this review, acupuncture should be advocated for the treatment of chronic LBP and included in the European Guidelines for this condition, given the equivalent effect sizes to treatments currently advocated (exercise, NSAIDS, behavioral treatments vs. no treatment).[82] It is more difficult to make conclusions about acupuncture as an adjunct to conventional treatment as there is such a wide variety of treatments included, not all of which are evidence based. However, the evidence for acupuncture as a cost effective adjunct to standard medical care is clear cut and therefore should be advocated. The effectiveness of acupuncture alone in comparison with conventional therapies is conflicting and requires more research. Another major area for further work stems from the finding that acupuncture is not more effective than a physiologically active sham control.

Although the reporting and methodologic quality of the studies have been improved in recent years, in terms of detailed reporting of acupuncture treatment, larger sample sizes, longer-term follow-up, blinding and intention-to-treat analysis etc., there is still lack of consensus (and thus guidelines) with regards to adequate acupuncture treatment (number of needles inserted, needle manipulation technique, treatment frequency and sessions, appropriate cointerventions etc.). We therefore suggest that future trials should focus on such areas where there are few or no trials to guide practice.


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