Should thread-embedding and auricular acupuncture be combined rather than used individually for non-specific chronic low back pain?: A double-blinded, randomized, sham-controlled trial
Abstract
Background Non-specific chronic low back pain (NCLBP), the most common type, is a leading cause of global disability. The combined effect of thread-embedding acupuncture (TEA) and auricular acupuncture (AA) remains unclear. This study evaluates whether combining TEA and AA improves NCLBP management compared to either alone. Methods In this double-blind randomized controlled trial, 168 NCLBP patients were randomized into four groups (n = 42): TEA+AA, TEA+sham AA, AA+sham TEA, or sham both, alongside conventional treatment. The intervention lasted 4 weeks with a 4-week follow-up. The primary outcome was the Oswestry Disability Index (ODI); secondary outcomes included pain score, paracetamol use, quality of life, global improvement, and adverse events (AEs). Results In the intention-to-treat analysis, the acupuncture groups showed significantly lower ODI percentage scores compared to the sham group (p < 0.0001). Both the TEA+AA and TEA+sham AA groups outperformed the AA+sham TEA group (mean differences [MD]:9.1 and -7.5, respectively; p < 0.0001) at week 4 and achieved the minimal clinically important difference (MCID) during follow-up. The TEA+AA group showed greater improvement than the TEA+sham AA group at weeks 2 and 6; however, these differences did not reach the MCID. Secondary effectiveness outcomes followed a similar trend. The results were consistent with the per-protocol analysis. AEs were mild and self-limiting. Conclusion TEA and AA are safe and effective adjuncts…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 168 participants or records.
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