ACUPUNCTURE FOR ACUTE NON-SPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED PLACEBO TRIAL

Background: Acute non-specific low back pain(LBP)is defined as the duration of an episode of low back pain persisting for less than 6 weeks that is not attributed to a recognizable or known specific disease. Objectives: Evaluate the effectiveness of acupuncture on pain, functional status and quality of life using Yamamoto's method on patients with acute non-specific LBP. Methods: Eighty patients with acute non-specific LBP were randomly allocated to an intervention and control group. The intervention group underwent treatment with five real acupuncture sessions. The control group was submitted to five non-penetrating acupuncture sessions. Throughout the study,both groups were instructed to take non-steroidal anti-inflammatory drugs (NSAID) as needed and record daily intake on a form. All subjects were evaluated by a blinded examiner at baseline, 3, 7, 14, 21 and 28 days. A pain visual analogue scale (VAS), Roland-Morris (RM), SF-36 and Likert scale were used. The number of visits to the doctor and NSAID consumption were considered co-interventions. Following treatment,patients were asked whether they thought they had undergone actual acupuncture or the placebo treatment. Statistical analysis was performed using the Student's t-test to compare the baseline characteristics of the groups and analysis of variance (ANOVA) with repeated measurements to assess inter/intra-group changes. The primary outcome was to detect a 2-point reduction in pain VAS; the minimal clinically important difference (MCID) for the RM scale was a reduction of 2.5 points. Results: There were no significant differences in the baseline characteristics between the two groups.Eighty patients completed the study and intention-to-treat analysis was performed.The intervention group showed a significant improvement in the pain VAS,functional status, bodily pain and vitality (assessed by the SF-36) after 14 days and an immediate improvement in the pain VAS at 3 days. Physical function (assessed by the SF-36) revealed a significant improvement after 21 days. There was also a reduction in NSAID intake in this group. There was no significant difference between groups regarding the Likert scale or number of visits to the doctor. Thirty-six patients in the placebo group believed they had received actual acupuncture,thereby supporting the credibility of non-penetrating placebo used in this study. Conclusion: Acupuncture was more effective than non-penetrating placebo regarding the pain VAS, functional status, bodily pain, vitality and physical function (assessed by the SF-36) and in decreasing NSAID intake. Acupuncture was ineffective regarding the other quality of life domains, Likert scale and number of visits to the doctor. References: 1. Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW et al. Acupuncture and dry-needling for low back pain. Issue 4; 2007 [cited 2008 Feb 28]. In: The Cochrane Database of Systematic Reviews [Internet]. Oxford: Update Software. Available from: http://cochrane.bvsalud.org/cochrane/show.php?db=reviews&mfn=700&id=〈=pt&dblang=&lib=COC Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 68, supplement 3, year 2009, page 702Session: Back pain, mechanical musculoskeletal problems, local soft tissue disorders (Poster Presentations )