Meta Analysis the Effectiveness of Acupuncture vs Sham Acupuncture on Low Back Pain
Abstract
Background: Low Back Pain is pain, aches and pains that occur in the lower back area and can be local pain or radicular pain. Acupuncture is a non-pharmacological therapy that can be used as an option to treat low back pain. This study aims to examine the effectiveness of acupuncture and sham acupuncture on reducing pain in cases of low back pain.
Subjects and Method: Meta-analysis was carried out with PICO as follows: The population in this study were patients with low back pain with an age range of 20-95 years. Intervention in the form of acupuncture therapy. Comparison in the form of sham acupuncture. Outcome in the form of pain scale. A meta-analysis study was applied to this study with electronic data sources Clinical Key, Google Scholar, MEDLINE/PubMed, Science Direct, Scopus, and Springer. The article used is a full-text article with a Randomized Control Trial (RCT) study design. There are 9 articles used in this study. Articles were analyzed using the Review Manager 5.3 application. The results of this study aim to determine the Standardized Mean difference (SMD) and the heterogeneity of the research sample.
Results: The heterogeneity in the results of this study was I^2=79%; p < 0.001, so it was analyzed by Random Effects Model (REM). Acupuncture was more effective in reducing pain than sham/placebo acupuncture, with a statistical significance of (SMD -0.59; 95% CI = -0.88 to -0.30; p<0.001.
Conclusion: Acupuncture is more effective than sham/placebo acupuncture in reducing pain scale in cases of low back pain.
Keywords: Acupuncture, Sham Acupuncture, Low Back Pain
Correspondence: Nurtama Aditya Nugraha. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: nurtamaaditya@gmail.com. Mobile: +6282220212767.
Indonesian Journal of Medicine (2021), 06(03): 336-346
https://doi.org/10.26911/theijmed.2021.06.03.11
References
Andarmoyo S (2013). Konsep dan Proses Keperawatan Nyeri (Pain Nursing Concepts and Processes). Ar-Ruzz: Yogyakarta.
Andini F (2015). Risk factor of low back pain in workers. Med J Lampung University. 4(1): 12-19. https://juke.kedokteran.unila.ac.id/index.php/majority/article/view/495.
Carolyn E, Manheimer E, Pirotta MV, dan White AR (2008). Acupuncture for pelvic and back pain in pregnancy: a systematic review. J Obstet Gynecol. 198(3): 254-259. https://doi.org/10.1016/j.ajog.2007.11.008.
Duthey B (2013). Background Paper 6.24 Low back pain. http://www.who.-int/medicines/areas/priority_medicines/BP6_24LBP.pdf
Fuentes RC, Organ B, Creech J, Broszko CM, Nashelsky J (2020). Acupuncture for low back pain. Can Fam Physician, 66(3), 186-187.
Godson DR, Wardle JL (2019) ‘Accuracy and Precision in Acupuncture Point Location: A Critical Systematic Review’, J Acupunct Meridian Stud. Korean Pharmacopuncture Institute, 12(2), pp. 52–66. doi: 10.1016/j.jams.2018.10.009.
Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S (2018). The global spine care Initiative: a summary of the global burden of low back and neck pain studies. Eur. Spine J, 27(6), 796-801.
Klimek L, Bergmann KC, Biedermann T, Bousquet J, Hellings P, Jung, K, Merk H, et al. (2017). Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care. Allergo J Int. 26(1): 16–24. doi:10.1007/s40629-016-0006-7.
Lee JH, Choi TY, Lee MS, Lee H, Shin BC, Lee H (2013). Acupuncture for acute low back pain: a systematic review. Clin J Pain. 29(2): 172-185. https://doi.org/10.1097/ajp.0b013e31824909f9.
Mardana IK, Aryasa T (2017). Penilaian Nyeri Smf/Bagian Anestesiologi Dan Terapi Intensif (Pain Assessment Smf/ Department of Anesthesiology and Intensive Therapy). Fakultas Kedokteran Universitas Udayana RSUP Sanglah. Denpasar.
Meliala L (2004). Nyeri Punggung Bawah (Lower Back Pain). Kelompok Studi Nyeri Perhimpunan Dokter Spesialis Saraf Indonesia. Jakarta.
Murti B (2018). Prinsip dan Metode Riset Epidemiologi (5th ed) (Epidemiological Research Principles and Methods (5th ed)). Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.
Ratnasari D, Made N, Ratna W, Judha M (2013). Pengaruh Pemberian Guided Imagery Terhadap nyeri pada pasien post operasi fraktur di RSUD Panem-bahan Senopati Bantul. http://journal.respati.ac.id/index.php/medika/article/viewFile/21/17.
Saputra K, Sudirman S (2009). Akupunktur untuk Nyeri dengan Pendekatan Neu-rosain (Acupuncture for Pain with a Neuroscience Approach). Jakarta: CV Sagung Seto.
Shergis JL, Ni X, Jackson ML, Zhang AL, Guo X, Li Y, Xue CC (2016). A systematic review of acupuncture for sleep quality in people with insomnia. Complement Ther Med 26: 11–20. doi: 10.1016/j.ctim.2016.02.007.
Shin JS, Ha IH, Lee TG, Choi Y, Park BY, Kim MR, Lee MS (2011). Motion style acupuncture treatment (MSAT) for acute low back pain with severe dis-ability: a multicenter, randomized, controlled trial protocol. BMC CompleAndarmoyo S (2013). Konsep dan Proses Keperawatan Nyeri (Pain Nursing Concepts and Processes). Ar-Ruzz: Yogyakarta.
Andini F (2015). Risk factor of low back pain in workers. Med J Lampung University. 4(1): 12-19. https://juke.kedok-teran.unila.ac.id/index.php/majority/article/view/495.
Carolyn E, Manheimer E, Pirotta MV, dan White AR (2008). Acupuncture for pelvic and back pain in pregnancy: a systematic review. J Obstet Gynecol. 198(3): 254-259. https://doi.org/10.1016/j.ajog.2007.11.008.
Duthey B (2013). Background Paper 6.24 Low back pain. http://www.who.int/medicines/areas/priority_medicines/BP6_24LBP.pdf
Fuentes RC, Organ B, Creech J, Broszko CM, Nashelsky J (2020). Acupuncture for low back pain. Can Fam Physician , 66(3), 186-187.
Godson DR, Wardle JL (2019) ‘Accuracy and Precision in Acupuncture Point Location: A Critical Systematic Review’, J Acupunct Meridian Stud. Korean Pharmacopuncture Institute, 12(2), pp. 52–66. doi: 10.1016/j.jams.2018.10.009.
Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S (2018). The global spine care Initiative: a summary of the global burden of low back and neck pain studies. Eur. Spine J, 27(6), 796-801.
Klimek L, Bergmann KC, Biedermann T, Bousquet J, Hellings P, Jung, K, Merk H, et al. (2017). Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care. Allergo J Int. 26(1): 16–24. doi:10.1007/s40629-016-0006-7.
Lee JH, Choi TY, Lee MS, Lee H, Shin BC, Lee H (2013). Acupuncture for acute low back pain: a systematic review. Clin J Pain. 29(2): 172-185. https://doi.org/10.1097/ajp.0b013e31824909f9.
Mardana IK, Aryasa T (2017). Penilaian Nyeri Smf/Bagian Anestesiologi Dan Terapi Intensif (Pain Assessment Smf/ Department of Anesthesiology and Intensive Therapy). Fakultas Kedokteran Universitas Udayana RSUP Sanglah. Denpasar.
Meliala L (2004). Nyeri Punggung Bawah (Lower Back Pain). Kelompok Studi Nyeri Perhimpunan Dokter Spesialis Saraf Indonesia. Jakarta.
Murti B (2018). Prinsip dan Metode Riset Epidemiologi (5th ed) (Epidemiological Research Principles and Methods (5th ed)). Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.
Ratnasari D, Made N, Ratna W, Judha M (2013). Pengaruh Pemberian Guided Imagery Terhadap nyeri pada pasien post operasi fraktur di RSUD Panem-bahan Senopati Bantul. http://journal.respati.ac.id/index.php/medika/article/viewFile/21/17.
Saputra K, Sudirman S (2009). Akupunktur untuk Nyeri dengan Pendekatan Neurosain (Acupuncture for Pain with a Neuroscience Approach). Jakarta: CV Sagung Seto.
Shergis JL, Ni X, Jackson ML, Zhang AL, Guo X, Li Y, Xue CC (2016). A systematic review of acupuncture for sleep quality in people with insomnia. Complement Ther Med 26: 11–20. doi: 10.1016/j.ctim.2016.02.007.
Shin JS, Ha IH, Lee TG, Choi Y, Park BY, Kim MR, Lee MS (2011). Motion style acupuncture treatment (MSAT) for acute low back pain with severe dis-ability: a multicenter, randomized, controlled trial protocol. BMC Complement Altern Med. 11(1): 127. https://doi.org/10.1016/j.pain.2013.03.013.
Sulaeman, Azizah Y, Kunaefi, Dermawan T (2015). Low back pain (LBP) pada pekerja di divisi minuman tradisional (Studi Kasus CV Cihanjuang Inti Teknik (Low back pain in workers in the traditional beverage division (Case Study of CV Cihanjuang Inti Teknik). Jurnal Teknik Lingkungan. 21(2): 201 – 211.
White A, Ernst E (2004). A brief history of acupuncture. Rheumatology. 43(5): 662–663. https://doi.org/10.1093/rheumatology/keg005.
Wijaya S (2013). Akupunktur metode penghilang nyeri dari masa ke masa (Acu-puncture pain relief method from time to time). Artikel Penyegar. Fakultas Kedokteran Universitas Sriwijaya.
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, et al. (2020). Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 8(6): 299–299. https://dx.doi.org/10.21037%2Fatm.2020.02.175.
Xu M, Yan S, Yin X, Li X, Gao S, Han R, Wei L, et al. (2013). Acupuncture for chronic low back pain in long-term follow-up: a meta-analysis of 13 randomized controlled trials. Am J Chinese Med. 41(01): 1-19. https://doi.org/10.1142/s0192415x13500018.ment Altern Med. 11(1): 127. https://doi.org/10.1016/j.pain.2013.03.013.
Sulaeman, Azizah Y, Kunaefi, Dermawan T (2015). Low back pain (LBP) pada pekerja di divisi minuman tradisional (Studi Kasus CV Cihanjuang Inti Teknik (Low back pain in workers in the traditional beverage division (Case Study of CV Cihanjuang Inti Teknik). Jurnal Teknik Lingkungan. 21(2): 201–211.
White A, Ernst E (2004). A brief history of acupuncture. Rheumatology. 43(5): 662–663. https://doi.org/10.1093/rh-eumatology/keg005.
Wijaya S (2013). Akupunktur metode peng-hilang nyeri dari masa ke masa (Acupuncture pain relief method from time to time). Artikel Penyegar. Fakultas Kedokteran Universitas Sriwijaya.
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, et al. (2020). Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 8(6): 299–299. https://dx.doi.org/10.21037%2Fatm.2020.02.175.
Xu M, Yan S, Yin X, Li X, Gao S, Han R, Wei L, et al. (2013). Acupuncture for chronic low back pain in long-term follow-up: a meta-analysis of 13 randomized controlled trials. Am J Chinese Med. 41(01): 1-19. https://doi.org/10.1142-/s0192415x13500018.
