Meta-Analysis: The Effectiveness of Acupucture in Reducing Pain and Improving Quality of Life in Patients with Low Back Pain
Abstract
Background: In Indonesia, low back pain is a common health problem that can interfere with a person's productivity in carrying out activities due to the manifestations of the pain it causes. Acupuncture therapy is one of the complementary treatments that is quite effective in reducing the intensity of low back pain. This study aims to estimate the effectiveness of acupuncture therapy to reduce pain and improve quality of life in patients with low back pain.
Subjects and Method: This study is a systematic review and meta-analysis with PICO, Population: Low back pain patients, Intervention: Acupuncture therapy, Comparison: No acupuncture therapy, Outcome: Pain reduction and quality of life improvement. It was measured using the Oswestry Disability Index. The article search process was carried out between 2006-2022 using 3 databases, including Google Scholar, PubMed, and Science Direct. The keywords used in the database search were “acupuncture” AND “oswestry disability index” AND “quality of life” AND “low back pain”. The inclusion criteria for full text articles using a Randomized Controlled Trial (RCT) study design by including the results of the study in the form of the number of respondents, the mean and standard deviation (SD) values, for articles using English and Indonesian. Articles that have met the requirements are analyzed using the RevMan 5.3 application.
Results: There are 9 articles that meet quantitative requirements and are divided into 2 categories according to independent variables with a Randomized Controlled Trial (RCT) study design originating from Spain, Australia, South Korea, Brazil, Germany and England, which were carried out in a meta-analysis in this study. Meta-analysis of 7 articles showed estimates that acupuncture therapy was effective in reducing pain in LBP patients. Patients experienced a decrease in pain 0.32 units higher than those who were not given acupuncture therapy (SMD = 0.32; 95% CI= -0.46 to -0.17; p <0.001). Meanwhile, a meta-analysis of 9 articles showed the estimation of the effect of effective acupuncture therapy on improving the quality of life in LBP patients. Patients experienced an improvement in quality of life 0.52 units higher than those who were not given acupuncture therapy (SMD = 0.52; 95% CI= 0.22 to 0.81; p= 0.006).
Conclusion: Acupuncture therapy is effective in reducing pain and improving the quality of life of LBP patients.
Keywords: acupuncture, low back pain, quality of life, oswestry disability index, meta-analysis
Correspondence: Frannesty Estu Winahyu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: frannestyestuwinahyu@gmail.com. Mobile: +6285228783882.
Indonesian Journal of Medicine (2022), 07(03): 313-325
https://doi.org/10.26911/theijmed.2022.07.03.08
References
Armstrong K, Gokal R, Chevalier A, Todorsky W, Lim M (2017). Microcurrent point stimulation applied to lower back acupuncture points for the treatment of nonspecific neck pain. J Altern Complement Med. 23(4):295299. Doi:10.1089/acm.2016.0313.
Cohen MM, Smit DV, Andrianopoulos N (2017). Acupuncture for analgesia in the emergency department: A multicentre, randomised, equivalence and noninferiority trial. Med J Aust. 206(11):494499. Doi:10.5694/mja16.00771.
Comachio J, Oliveira Magalhães M, Nogueira Burke T (2015). Efficacy of acupuncture and electroacupuncture in patients with nonspecific low back pain: Study protocol for a randomized controlled trial. Trials. 16(1):17. Doi:10.1186/s1306301508507.
Ditjen Yankes (2018). Petunjuk teknis sistem antrian online (Online queuing system technical manual). Jakarta: Kemenkes RI.
Depkes RI (1999). Rencana pembangunan kesehatan menuju indonesia sehat 2010 (Health development plan towards healthy Indonesia 2010). Jakarta:http://library.poltekkespalembang.ac.id/gigi/index.php?p=show_detail&id=584.
Haake M, Muller HH, SchadeBrittinger C, Basler HD, Schafer H, Maier C, Endres HG (2008). German acupuncture trials for chronic low back pain. Arch. Intern. Med. 168 (9):1010. Doi: 10.1001/archinte.167.17.1892.Hasanah U, Murti B, Prasetya H (2021). The effectiveness of aromatherapy and music therapy to reduce pain during stage1 of birth delivery: A Meta-Analysis. J Matern Child Health. 6(3): 295306. Doi:10.26911/thejmch.2021.06.03.04.
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, Williams G, et al. (2014). The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 73(6):968974. Doi:10.1136/annrheumdis2013204428.
Indana AZ, Rahardjo SS, Prasetya H (2021). Metaanalysis the effectiveness of isometric relaxation and laser therapy in reducing myofascial pain syndrome on musculus upper trapezius. J Epidemiol Public Heal. 6(2): 245255. Doi:10.26911/jepublichealth.2021.06.02.11.
Kuntono HP (2011). Nyeri secara umum dan osteoarthritis lutut dari aspek fisioterapi. Surakarta: Muhammadiyah University Press.
Noer A, Rahardjo SS, Prasetya H (2021). Meta analysis the effect of acupunctur therapy and ultrasound therapy to reduce pain caused by carpal tunnel syndrome. Indones J Med. 6(4):399411. Doi:10.26911/theijmed.2021.06.04.06.
Nugraha NA, Murti B, Prasetya H (2021). Meta analysis the effectiveness of acupuncture vs sham acupuncture on low back pain. Indones J Med. 6(3): 336346. Doi:10.26911/theijmed.2021.06.03.11. Patrianingrum M, Ezra O, Eri S (2015). Prevalensi dan faktor risiko nyeri punggung bawah di lingkungan kerja anestesiologi rumah sakit dr. hasan sadikin bandung. J. Anestesi Perioperatif. 3(1): 47–56.
Putri SADMM, Kristiyanto A, Prasetya H (2021). Metaanalysis the effectiveness of mckenzie exercise to reduce pain in patients with nonspecific low back pain. J Epidemiol Public Heal. 6(1):3341. Doi:10.26911/jepublichealth.2021.06.01.04.
Prasetya H, Kusumawati HN, Wardiyatmi W (2021). The effectiveness of hypnotherapy in reducing pain in patients with cervical cancer. Indones J Med. 6(2):152158. Doi:10.26911/theijmed.2021.06.02.04.
Safitri D (2010). Hubungan antara kepercayaan diri dengan penyesuaian sosial mahasiswa di fakultas psikologi UIN Maulana Malik Ibrahim malang (The relationship between selfconfidence and social adjustment of students at the psychology faculty of UIN Maulana Malik Ibrahim Malang). Skripsi (tidak diterbitkan): Fakultas Psikologi Universitas Islam Negeri (UIN) Maulana Malik Ibrahim Malang.
Susilo FE, Kristiyanto A, Prasetya H (2021). Meta analysis the effect of acupuncture therapy on pain reduction in osteoarthritis patients. Indones J Med. 6(1):95103. Doi:10.26911/theijmed.2021.06.01.1.
Setiawan C, Tamtomo DG, Prasetya H (2021). The effect of kinesio taping on the reduction of pain in pati with carpal tunnel syndrome: Meta Analysis. Indones J Med. 6(1):104111. Doi:10.26911/theijmed.2021.06.01.11.