Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial

2006 ◽  
Vol 24 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Kazunori Itoh ◽  
Yasukazu Katsumi ◽  
Satoko Hirota ◽  
Hiroshi Kitakoji

Introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65–91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P<0.001) and Roland Morris Questionnaire scores (P<0.01) than the sham control group. There were significant within-group reductions in pain in both groups during the trigger point acupuncture phase but not in the sham treatment phase. However, the beneficial effects were not sustained. Conclusion These results suggest that trigger point acupuncture may have greater short term effects on low back pain in elderly patients than sham acupuncture.

Author(s):  
Aurora Castro-Méndez ◽  
Inmaculada Concepción Palomo-Toucedo ◽  
Manuel Pabón-Carrasco ◽  
Javier Ramos-Ortega ◽  
Juan Antonio Díaz-Mancha ◽  
...  

Excessive foot pronation has been reported as being related to chronic low back pain symptoms and risk factors in sports-specific pathologies. Compensating custom-made foot orthotics treatment has not been entirely explored as an effective therapy for chronic low back pain (CLBP). This study aims to observe the effects of custom-made foot orthoses, in subjects with foot pronation suffering from CLBP. A total of 101 patients with nonspecific CLBP and a pronated foot posture index (FPI) were studied. They were randomized in two groups: an experimental one (n = 53) used custom-made foot orthotics, and the control group (n = 48) were treated with non-biomechanical effect orthoses. The CLBP was measured using the Oswestry Disability Index (ODI) Questionnaire and a visual analogue scale (VAS), both for lower back pain. The symptoms were evaluated twice, at first when the subject was included in the study, and later, after 4 weeks of treatment. The analysis of outcomes showed a significant decrease in CLBP in the custom-made foot orthoses participants group (p < 0.001 ODI; p < 0.001 VAS). These findings suggest that controlling excessive foot pronation by using custom-made foot orthoses may significantly contribute to improving CLBP.


2021 ◽  
pp. 229-236
Author(s):  
Yi-Chien Peng ◽  
Chung-Yuan Hsu ◽  
Wen-Tzu Tang

The purpose of this study was to investigate whether low-handicap elite golfers with chronic low back pain (CLBP) exhibit deficits in dynamic postural control and whether CLBP affects golfers in terms of their golf swing parameters. A total of fifteen Division 1 college golfers were recruited as participants. Of these, six of whom experienced CLBP, while the remaining participants were healthy. In this study, CLBP was defined as experiencing chronic pain symptoms for more than six months. The Star Excursion Balance Test (SEBT) was administered to examine dynamic posture control in both groups. The TrackMan Golf Launch Monitor Simulator was used to collect data on the performance parameters of the swing of the participants. The results for both feet in the medial, lateral, posterior, posteromedial, and posterolateral directions indicated that the CLBP group scored lower than the control group. However, the CLBP group scored higher for the right foot in the anterolateral direction. The parameters for the club speed and ball carry of the CLBP group were lower than those of the control group. Further, the CLBP group exhibited a more upright swing plane relative to the control group. Taken together, our findings suggest that SEBT may be feasible and highly accessible to assess golf swing performance of elite players with CLBP.


Author(s):  
Ecenur Atli ◽  
Dilber Karagozoglu Coskunsu ◽  
Zeynep Turan ◽  
Ozden Ozyemisci Taskiran

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p<0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p>0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p>0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.


2009 ◽  
Vol 27 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Mike Cummings

In October 2000 the German Federal Committee of Physicians and Health Insurers recommended that special Model Projects on Acupuncture (“ Modellvorhaben Akupunktur”) be developed in order to determine the evidence-based role of acupuncture in the treatment of certain illnesses. This paper presents a summary of the main randomised controlled trials performed as part of these projects, and the associated economic analyses. Overall the results show that acupuncture is effective in practice for a range of chronic conditions, and it seems likely to have acceptable cost utility (at least at a rate of ¢35 per session). Sham acupuncture, in the form of minimal off-point needling in a therapeutic context, also appears to be effective, being no different to prophylactic medication in migraine, and superior to guideline-based standard care in chronic low back pain. In patients recruited to acupuncture trials, the response to treatment does not differ between those that agree to be randomised and those that do not. This suggests that the results of the pragmatic Acupuncture in Routine Care studies are applicable to patients from the general population who express a preference for acupuncture. In conclusion, acupuncture appears to be effective in a range of chronic conditions and it seems to have acceptable cost-effectiveness in Western health economic terms. These programmes of research do not confirm the hypothesis that needling at specific points is essential to achieve satisfactory clinical effects of acupuncture. Sham acupuncture, in the form of minimal off-point needling in a therapeutic context, is unlikely to be an inactive placebo. In April 2006, the German health authorities decided that acupuncture would be included into routine reimbursement by social health insurance funds for chronic low back pain and chronic osteoarthritis of the knee.


Spine ◽  
1997 ◽  
Vol 22 (7) ◽  
pp. 786-797 ◽  
Author(s):  
Francisco M. Kovacs ◽  
Víctor Abraira ◽  
Francisco Pozo ◽  
David G. Kleinbaum ◽  
Juan Beltrán ◽  
...  

2016 ◽  
Vol 124 (1) ◽  
pp. 150-158 ◽  
Author(s):  
Regina P. Schukro ◽  
Matthias J. Oehmke ◽  
Angelika Geroldinger ◽  
Georg Heinze ◽  
Hans-Georg Kress ◽  
...  

Abstract Background Among patients with chronic low back pain (CLBP), approximately 37% show signs of a neuropathic pain component (radicular pain). Treatment of this condition remains challenging. Therefore, the current study aimed to investigate the efficacy of duloxetine in the treatment of CLBP patients with neuropathic leg pain. Methods The study was conducted as a prospective, randomized, placebo-controlled, double-blind crossover trial. CLBP with a visual analog scale (VAS) score greater than 5 and a neuropathic component that was assessed clinically and by the painDETECT questionnaire (score &gt; 12) were required for inclusion. Patients were randomly assigned to either duloxetine or placebo for 4 weeks followed by a 2-week washout period before they crossed over to the alternate phase that lasted another 4 weeks. Duloxetine was titrated up to 120 mg/day. The primary outcome parameter was mean VAS score during the last week of treatment in each phase (VASweek4). Results Of 41 patients, 21 patients completed both treatment phases. In the intention-to-treat analysis (n = 25), VASweek4 was significantly lower in the duloxetine phase compared with placebo (4.1 ± 2.9 vs. 6.0 ± 2.7; P = 0.001), corresponding to an average pain reduction of 32%. The painDETECT score at the end of each treatment phase was significantly lower in the duloxetine phase compared with placebo (17.7 ± 5.7 vs. 21.3 ± 3.6 points; P = 0.0023). Adverse events were distributed equally between the duloxetine (65%) and placebo phases (62%) (P = 0.5). Conclusion In this crossover study, duloxetine proved to be superior to placebo for the treatment of CLBP with a neuropathic leg pain.


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