Electroacupuncture at Traditional Acupoints or Myofascial Trigger Points for Chronic Nonspecific Low Back Pain: High or Alternated Frequency? A Double-Blinded Randomized Controlled Trial

Background: Chronic nonspecific low back pain (cNLBP) can be effectively treated by electroacupuncture (EA) at traditional acupoints (TAPs) and myofascial trigger points (MTrPs). However, the optimal type and frequency of stimulation (alternated frequency [AF] and high frequency [HF]) remain unclear. This study aimed to explore this.Methods: A double-blinded randomized controlled trial was conducted with four treatment groups: EA using AF at MTrPs (MTP-AF group), HF at MTrPs (MTP-HF group), AF at TAPs (TAP-AF group), and HF at TAPs (TAP-HF), each with 40 middle-aged cNLBP patients. The AF was 2/100 Hz and HF was 100 Hz. Pain-visual analog scale (pain-VAS), paracetamol requirement, Oswestry disability index (ODI) score, global improvement, and adverse effects (AEs) were monitored.Results: After 4 weeks, groups of EA targeting MTrPs and TAPs with the same frequency showed no significant differences. Groups using AF demonstrated significantly superior pain-VAS and ODI percentage score reductions compared with HF groups, extending at least 4 weeks post-EA. All groups showed consistent results in paracetamol use, global improvement, and safety. Subgroup analysis indicated that EA with AF at MTrPs provided better results in patients aged >= 60-65 years.Conclusions: EA at MTrPs and TAPs demonstrated similar effects on cNLBP. However, an AF proves more effective than an HF, potentially maintaining this trend in the short term. Older patients may respond better to EA at MTrPs with AF. Future studies may explore combined MTrPs and TAPs for cNBLP treatment with a broader age range and more diverse demographic groups.