PainRelief.com Interview with:
Jiang-Ti Kong, MD, Division of Pain Medicine
Department of Anesthesiology, Perioperative and Pain Medicine
Stanford University School of Medicine
Palo Alto, CA
PainRelief.com: What is the background for this study?
Response: Chronic low back pain is the most common chronic pain condition. Its treatment can be challenging, particularly given the side effects from conventional treatments. These include surgical complications and medication side effects, such as opioid dependence and kidney/liver damage. Acupuncture is receiving increasing attention as an alternative treatment for chronic low back pain. However, multiple large studies showed similar effect sizes between real acupuncture and sham (control) acupuncture. Interestingly, most of these studies involve the use of manual acupuncture, while pre-clinical studies suggest the use of electro-acupuncture may lead to greater analgesia than control. Few have formally studied the clinical effect of electro-acupuncture in a randomized, controlled setting. A major objective of our study was to investigate the clinical effect of electro-acupuncture relative to sham control in a randomized, participant- and assessor-blinded, clinical trial.
Equally importantly, we were interested in exploring predictors of clinical response to electro-acupuncture, because, in general, about 40-60% of individuals treated with acupuncture experience clinically significant improvement. It would be helpful to identify responders to acupuncture before treatment initiation. We explored potential predictors of clinical response to electro-acupuncture by performing univariate, treatment heterogeneity and multivariate analysis between baseline participant characteristics and clinical outcome, defined as either pain reduction or improvement in function.