Research: MOLSBERGER and co-workers

Listed in Issue 89

Abstract

MOLSBERGER and co-workers, Orthopedic Surgery and Research, Kasernenstr. 1b, 40213 Duesseldorf, Germany, molsberger@t-online.de, have conducted a randomized controlled trial of acupuncture in the orthopaedic management of chronic low back pain.

Background

The aim of the study was to answer the question if a combination of acupuncture and conservative orthopaedic treatment is an improvement over conservative orthopaedic treatment alone in chronic low back pain (LBP).

Methodology

In this prospective, randomized controlled trial with three parallel groups, patient and observer blindness for real and sham acupuncture. and a follow-up of 3 months, 186 in-patients at a LBP rehabilitation centre with a history of at least 6 weeks low back pain and a pain intensity of at least 50 on a scale from 0 to 100 were selected and randomly divided into three groups. Each group received 4 weeks of treatment: real acupuncture plus conservative orthopaedic treatment (real + COT), sham acupuncture (unspecific needling) plus COT (sham + COT), and conservative orthopaedic treatment only (nil + COT). The primary outcome measure was a reduction in the Pain VAS at 3 months follow-up, with pain reduction immediately after treatment as a secondary outcome measure.

Results

174 patients completed the treatment course, and 124 reported at 3 months follow-up. Immediately after treatment the Pain VAS was reduced by 65% in the real + COT group as compared to 34% in the sham + COT group and 43% in the nil + COT group (p = 0.02 for real vs. sham). At 3 months follow-up, the results were even more striking: 77% reduction in Pain VAS in the real + Cot group, 29% in the sham + COT group, and 14% in the nil + COT group (p = 0.0001 for real vs. both sham and nil). No difference was found in the mobility of patients or in the intake of analgesic medication.

Conclusion

Acupuncture can be an important supplement of conservative orthopaedic treatment in the management of chronic low back pain.

References

Molsberger AF, Mau J, Pawelec DB, Winkler J. Does acupuncture improve the orthopaedic management of chronic low back pain – a randomized, blinded, controlled trial with 3 months follow up. Pain 99 (3): 579-587, Oct 2002.

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