Acupuncture for chronic nonspecific low back pain: An overview of systematic reviews

IntroductionChronic nonspecific low back pain (cnLBP), which cannot be attributed to a specific pathology is very common. As a result acupuncture is frequently used by patients as a treatment option.This overview aimed to summarize and evaluate the available systematic reviews on the clinical effectiveness and cost-effectiveness of acupuncture for the management of cnLBP, and to identify the safety of acupuncture for the management of cnLBP.MethodsSystematic reviews of acupuncture and cnLBP were sourced from five databases. Publications between January 2003 and May 2014 were included for analysis. Quality appraisal of included systematic reviews was assessed by the Overview Quality Assessment Questionnaire.ResultsSeventeen systematic reviews were included. Five found that acupuncture was more effective when compared with a no treatment/waiting list control, as there were eight systematic reviews and meta-analysis providing positive and consistent findings. Seven systematic reviews providing positive findings of the comparison of acupuncture to sham acupuncture/passive modality treatment. Three systematic reviews of multiple RCTs also indicated positive and consistent findings of the comparison of acupuncture plus an intervention vs an intervention alone. Overall, findings on the effectiveness of acupuncture for cnLBP were consistent.ConclusionsAs there is a range of diverse acupuncture styles used for patients with cnLBP, future trials are needed to establish the standardization of acupuncture in terms of the length of treatment sessions, frequency of sessions, number of needles needed per treatment, placement of needle insertion, depth of needle insertion, and whether needle stimulation achieves De Qi.