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Rheumatology Advance Access originally published online on July 30, 2003
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Rheumatology 2003; 42: 1508-1517
© 2003 British Society for Rheumatology

Acupuncture for chronic low back pain in older patients: a randomized, controlled trial

C. F. Meng, D. Wang3, J. Ngeow1, L. Lao4, M. Peterson2 and S. Paget

Departments of Rheumatology, 1Pain Management/Anesthesiology and 2Research, Hospital for Special Surgery, New York, NY, 3Department of Pain Management/Anesthesiology, New York Hospital and 4Department of Complementary Medicine, University of Maryland, MD, USA.

Correspondence to: C. F. Meng, Hospital for Special Surgery, Rheumatology, 535 E. 70th Street, New York, NY 10021, USA. E-mail: mengc{at}hss.edu

Objective. To determine if acupuncture is an effective, safe adjunctive treatment to standard therapy for chronic low back pain (LBP) in older patients.

Methods. The inclusion criteria for subjects were: (i) LBP >=12 weeks and (ii) age >=60 yr; the exclusion criteria were (i) spinal tumour, infection or fracture and (ii) associated neurological symptoms. The subjects were randomized to two groups. The control group of subjects continued their usual care as directed by their physicians, i.e. NSAIDs, muscle relaxants, paracetamol and back exercises. Subjects in the acupuncture group in addition received biweekly acupuncture with electrical stimulation for 5 weeks. Outcome was measured by the modified Roland Disability Questionnaire (RDQ) at weeks 0, 2, 6 and 9. The primary outcome measure was change in RDQ score between weeks 0 and 6.

Results. Fifty-five patients were enrolled, with eight drop-outs. Twenty-four subjects were randomized to the acupuncture group and 23 were randomized to the control group. Acupuncture subjects had a significant decrease in RDQ score of 4.1 ± 3.9 at week 6, compared with a mean decrease of 0.7 ± 2.8 in the control group (P = 0.001). This effect was maintained for up to 4 weeks after treatment at week 9, with a decrease in RDQ of 3.5 ± 4.4 from baseline, compared with 0.43 ± 2.7 in the control group (P = 0.007). The mean global transition score was higher in the acupuncture group, 3.7 ± 1.2, indicating greater improvement, compared with the score in the control group, 2.5 ± 0.9 (P < 0.001). Fewer acupuncture subjects had medication-related side-effects compared with the control group.

Conclusions. Acupuncture is an effective, safe adjunctive treatment for chronic LBP in older patients.

KEY WORDS: Acupuncture, Chronic low back pain, Elderly patients, Randomized controlled trial.


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