Multicentre randomised controlled clinical trial of electroacupuncture with usual care for patients with non-acute pain after back surgery
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(7):19 Br J Anaesth. 2021 Mar;126(3): 692-699.What this means for my practice?
Study finding may suggest that the addition of electroacupuncture to a 4 week physical therapy and education program can improve pain and function in patients with non-acute low back pain after back surgery. However, these benefits do not persist beyond 8 weeks follow-up. Moreover, quality of life does not significantly improve with the addition of electroacupuncture treatment. This study was limited by the lack of blinding of patients and physicians as no sham treatment was used, as well as the recruitment of patients using bulletin boards on hospital websites or at hospitals which could have resulted in a self-selecting group of patients not reflected of the general population. Future studies are therefore required to confirm the results of this study.
Study Summary
One hundred and eight patients with non-acute low back pain after back surgery were randomized to receive 4 weeks of physical therapy and education with electroacupuncture treatment (n=54) or without acupuncture treatment (n=54). The primary outcome of interest was pain scores on a 100 point Visual Analog Scale (VAS). Secondary outcomes of interest included the Oswestry Disability Index (ODI), the Euro Quality of Life 5 Dimension (EQ-5D) quality of life questionnaire, and the incidence of adverse events. Outcomes were assessed at 3, 5, 8 and 12 weeks follow-up for VAS pain scores and ODI scores, as well as 5, 8 and 12 weeks for EQ-5D scores. Adverse events were assessed at each follow-up time-point. Results revealed statistically significantly lower VAS pain scores in the electroacupuncture group compared to the control group at 3 weeks (p=0.0063) and 5 weeks (p=0.0311) follow-up. Additionally, ODI scores were statistically significantly in favour of the electroacupuncture group at 3, 5 and 8 weeks follow-up (p<0.05 for all). No statistically significant differences were observed between the two groups in EQ-5D scores at all timepoints (p>0.05 for all). Moreover, 1 patient in the electroacupuncture group and 3 patients in the control group required additional treatment (p=0.6179). In the electroacupuncture group, 29 adverse events were reported, as well as 2 cases of hospitalization for traffic accidents. In the control group, 24 adverse events were reported, as well as 1 cases of hospitalization for appendicitis, 1 case of cystitis, and 3 cases of pain aggravation.
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