Integrative Acupuncture Care for Low back Pain: A Systematic Review

Low-back pain (LBP) is one of the most significant healthcare challenges affecting modern society, yet its most effective management approach remains unclear.  Previous reviews have evaluated the use of single complementary and alternative medicine therapies for LBP, but in practice it is common for patients to seek care from multiple practitioners and receive different types of therapies in combination.  The objective of this study is to review the literature on the effectiveness of an integrated approach that includes acupuncture for the management of LBP.

A literature search located seven randomized clinical trials that combined acupuncture with other therapies for LBP. Only English language papers were included.  The risk of bias within studies was evaluated using the Van Tulder scale. Modalities used with acupuncture included exercise, physiotherapy and conventional medical care. Three high quality studies examined the combination of acupuncture with conventional medicine for chronic LBP, and all found this treatment to be clinically effective, yielding the highest level of best evidence.  One high quality study found that acupuncture combined with exercise was also effective for chronic LBP. These studies used different outcome measures for pain and disability, making the effect size difficult to determine. This systematic review found that acupuncture combined with conventional medicine or exercise seems to be effective for treating chronic LBP. Results from this study highlight the need for further research on integrated care for LBP.