Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2004; 9: 40–1
To systematically review the available literature on acupuncture in relation to low back pain and to assess the reported methodology following the STRICTA guidelines.
Computerised searches of Medline, Amed, Cinahl, Embase, ProQuest, Sciences Direct and CCTR were undertaken between 1966 and 2004 for RCTs and between 1994 and 2004 for case studies, supplemented by hand-searching of reference lists of relevant articles. Textbooks were included in order to supplement the information on treatment parameters.
Nineteen RCTs, 25 case studies and nine standard textbooks were reviewed. In terms of treatment parameters, there was some consistency in the points, for example BL40, BL23, Ahshi point and BL60. The most frequently reported needle-retention time was 20 min and frequency of treatment was twice per week. Three types of control interventions were described: no treatment, conventional treatment and placebo TENS or sham needle groups. Five RCTs applied traditional Chinese medicine while the remaining RCTs applied prescriptive needling points. Experienced acupuncturists conducted acupuncture treatments in the majority of studies. Twelve RCTs included co-interventions or medication during the treatment period. Only three RCTs appeared to provide full details of the acupuncture procedure according to the STRICTA guidelines. However, more recent studies provide better detail of the treatment used.
The studies included in the review still have limitations and variations according to the STRICTA guidelines. However, using the STRICTA guidelines will lead to more rigorous trial design, more robust conclusions and better data to determine future research and practice.
