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• W4206021906 abstract "Chronic nonspecific low back pain (LBP) is very common; it is defined as pain without a recognizable etiology that lasts for more than three months. Some clinical practice guidelines suggest that acupuncture can offer an effective alternative therapy. This review is a split from an earlier Cochrane review and it focuses on chronic LBP.To assess the effects of acupuncture compared to sham intervention, no treatment, or usual care for chronic nonspecific LBP.We searched CENTRAL, MEDLINE, Embase, CINAHL, two Chinese databases, and two trial registers to 29 August 2019 without restrictions on language or publication status. We also screened reference lists and LBP guidelines to identify potentially relevant studies.We included only randomized controlled trials (RCTs) of acupuncture for chronic nonspecific LBP in adults. We excluded RCTs that investigated LBP with a specific etiology. We included trials comparing acupuncture with sham intervention, no treatment, and usual care. The primary outcomes were pain, back-specific functional status, and quality of life; the secondary outcomes were pain-related disability, global assessment, or adverse events.Two review authors independently screened the studies, assessed the risk of bias and extracted the data. We meta-analyzed data that were clinically homogeneous using a random-effects model in Review Manager 5.3. Otherwise, we reported the data qualitatively. We used the GRADE approach to assess the certainty of the evidence.We included 33 studies (37 articles) with 8270 participants. The majority of studies were carried out in Europe, Asia, North and South America. Seven studies (5572 participants) conducted in Germany accounted for 67% of the participants. Sixteen trials compared acupuncture with sham intervention, usual care, or no treatment. Most studies had high risk of performance bias due to lack of blinding of the acupuncturist. A few studies were found to have high risk of detection, attrition, reporting or selection bias. We found low-certainty evidence (seven trials, 1403 participants) that acupuncture may relieve pain in the immediate term (up to seven days) compared to sham intervention (mean difference (MD) -9.22, 95% confidence interval (CI) -13.82 to -4.61, visual analogue scale (VAS) 0-100). The difference did not meet the clinically important threshold of 15 points or 30% relative change. Very low-certainty evidence from five trials (1481 participants) showed that acupuncture was not more effective than sham in improving back-specific function in the immediate term (standardized mean difference (SMD) -0.16, 95% CI -0.38 to 0.06; corresponding to the Hannover Function Ability Questionnaire (HFAQ, 0 to 100, higher values better) change (MD 3.33 points; 95% CI -1.25 to 7.90)). Three trials (1068 participants) yielded low-certainty evidence that acupuncture seemed not to be more effective clinically in the short term for quality of life (SMD 0.24, 95% CI 0.03 to 0.45; corresponding to the physical 12-item Short Form Health Survey (SF-12, 0-100, higher values better) change (MD 2.33 points; 95% CI 0.29 to 4.37)). The reasons for downgrading the certainty of the evidence to either low to very low were risk of bias, inconsistency, and imprecision. We found moderate-certainty evidence that acupuncture produced greater and clinically important pain relief (MD -20.32, 95% CI -24.50 to -16.14; four trials, 366 participants; (VAS, 0 to 100), and improved back function (SMD -0.53, 95% CI -0.73 to -0.34; five trials, 2960 participants; corresponding to the HFAQ change (MD 11.50 points; 95% CI 7.38 to 15.84)) in the immediate term compared to no treatment. The evidence was downgraded to moderate certainty due to risk of bias. No studies reported on quality of life in the short term or adverse events. Low-certainty evidence (five trials, 1054 participants) suggested that acupuncture may reduce pain (MD -10.26, 95% CI -17.11 to -3.40; not clinically important on 0 to 100 VAS), and improve back-specific function immediately after treatment (SMD: -0.47; 95% CI: -0.77 to -0.17; five trials, 1381 participants; corresponding to the HFAQ change (MD 9.78 points, 95% CI 3.54 to 16.02)) compared to usual care. Moderate-certainty evidence from one trial (731 participants) found that acupuncture was more effective in improving physical quality of life (MD 4.20, 95% CI 2.82 to 5.58) but not mental quality of life in the short term (MD 1.90, 95% CI 0.25 to 3.55). The certainty of evidence was downgraded to moderate to low because of risk of bias, inconsistency, and imprecision. Low-certainty evidence suggested a similar incidence of adverse events immediately after treatment in the acupuncture and sham intervention groups (four trials, 465 participants) (RR 0.68 95% CI 0.46 to 1.01), and the acupuncture and usual care groups (one trial, 74 participants) (RR 3.34, 95% CI 0.36 to 30.68). The certainty of the evidence was downgraded due to risk of bias and imprecision. No trial reported adverse events for acupuncture when compared to no treatment. The most commonly reported adverse events in the acupuncture groups were insertion point pain, bruising, hematoma, bleeding, worsening of LBP, and pain other than LBP (pain in leg and shoulder).We found that acupuncture may not play a more clinically meaningful role than sham in relieving pain immediately after treatment or in improving quality of life in the short term, and acupuncture possibly did not improve back function compared to sham in the immediate term. However, acupuncture was more effective than no treatment in improving pain and function in the immediate term. Trials with usual care as the control showed acupuncture may not reduce pain clinically, but the therapy may improve function immediately after sessions as well as physical but not mental quality of life in the short term. The evidence was downgraded to moderate to very low-certainty considering most of studies had high risk of bias, inconsistency, and small sample size introducing imprecision. The decision to use acupuncture to treat chronic low back pain might depend on the availability, cost and patient's preferences." @default.
• W4206021906 created "2022-01-25" @default.
• W4206021906 creator A5001600404 @default.
• W4206021906 creator A5015198590 @default.
• W4206021906 creator A5029719892 @default.
• W4206021906 creator A5029731459 @default.
• W4206021906 creator A5029860011 @default.
• W4206021906 creator A5042830285 @default.
• W4206021906 date "2020-12-11" @default.
• W4206021906 modified "2023-10-01" @default.
• W4206021906 title "Acupuncture for chronic nonspecific low back pain" @default.
• W4206021906 cites W1010285967 @default.
• W4206021906 cites W105506365 @default.
• W4206021906 cites W1480584925 @default.
• W4206021906 cites W1480729244 @default.
• W4206021906 cites W1487422692 @default.
• W4206021906 cites W1520661377 @default.
• W4206021906 cites W1590418672 @default.
• W4206021906 cites W187218312 @default.
• W4206021906 cites W1939173887 @default.
• W4206021906 cites W194674713 @default.
• W4206021906 cites W1964032994 @default.
• W4206021906 cites W1977849332 @default.
• W4206021906 cites W1978302731 @default.
• W4206021906 cites W1979415624 @default.
• W4206021906 cites W1986215651 @default.
• W4206021906 cites W1992077458 @default.
• W4206021906 cites W1993561636 @default.
• W4206021906 cites W1999952110 @default.
• W4206021906 cites W2008426758 @default.
• W4206021906 cites W2010038561 @default.
• W4206021906 cites W2016053146 @default.
• W4206021906 cites W2017143125 @default.
• W4206021906 cites W2021310269 @default.
• W4206021906 cites W2023370307 @default.
• W4206021906 cites W2024992267 @default.
• W4206021906 cites W2026296699 @default.
• W4206021906 cites W2027927047 @default.
• W4206021906 cites W2028120220 @default.
• W4206021906 cites W2033570179 @default.
• W4206021906 cites W2037672678 @default.
• W4206021906 cites W2037698455 @default.
• W4206021906 cites W2038275203 @default.
• W4206021906 cites W2038491190 @default.
• W4206021906 cites W2038539495 @default.
• W4206021906 cites W2038693293 @default.
• W4206021906 cites W2042001772 @default.
• W4206021906 cites W2054883245 @default.
• W4206021906 cites W2057365143 @default.
• W4206021906 cites W2060208095 @default.
• W4206021906 cites W2061774845 @default.
• W4206021906 cites W2064296154 @default.
• W4206021906 cites W2064303779 @default.
• W4206021906 cites W2067041198 @default.
• W4206021906 cites W2070426225 @default.
• W4206021906 cites W2070810521 @default.
• W4206021906 cites W2078965823 @default.
• W4206021906 cites W2089451247 @default.
• W4206021906 cites W2094179922 @default.
• W4206021906 cites W2094776793 @default.
• W4206021906 cites W2101230162 @default.
• W4206021906 cites W2104037946 @default.
• W4206021906 cites W2108696783 @default.
• W4206021906 cites W2108969502 @default.
• W4206021906 cites W2111747753 @default.
• W4206021906 cites W2112094912 @default.
• W4206021906 cites W2116863239 @default.
• W4206021906 cites W2117065566 @default.
• W4206021906 cites W2123296258 @default.
• W4206021906 cites W2124239698 @default.
• W4206021906 cites W2126008018 @default.
• W4206021906 cites W2126701605 @default.
• W4206021906 cites W2132339792 @default.
• W4206021906 cites W2133225103 @default.
• W4206021906 cites W2134074752 @default.
• W4206021906 cites W2135452512 @default.
• W4206021906 cites W2137368640 @default.
• W4206021906 cites W2143536237 @default.
• W4206021906 cites W2143728664 @default.
• W4206021906 cites W2146154311 @default.
• W4206021906 cites W2148870133 @default.
• W4206021906 cites W2151212093 @default.
• W4206021906 cites W2151651256 @default.
• W4206021906 cites W2152751399 @default.
• W4206021906 cites W2156460216 @default.
• W4206021906 cites W2156993118 @default.
• W4206021906 cites W2157041856 @default.
• W4206021906 cites W2157298360 @default.
• W4206021906 cites W2158454384 @default.
• W4206021906 cites W2160451642 @default.
• W4206021906 cites W2161344815 @default.
• W4206021906 cites W2161813573 @default.
• W4206021906 cites W2164282722 @default.
• W4206021906 cites W2166504913 @default.
• W4206021906 cites W2167489256 @default.
• W4206021906 cites W2169973570 @default.
• W4206021906 cites W2320399503 @default.
• W4206021906 cites W2331760206 @default.
• W4206021906 cites W2334326665 @default.
• W4206021906 cites W2348017951 @default.

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