Acupuncture vs Noninsertive Sham Acupuncture in Aging Patients with Degenerative Lumbar Spinal Stenosis: A Randomized Controlled Trial

Background: Acupuncture is commonly used to treat degenerative lumbar spinal stenosis in Asian countries. However, rigorous data regarding the efficacy and safety of acupuncture for aging patients are currently lacking. Methods: Eighty patients older than 50 years were assigned randomly to the acupuncture group or the noninsertive sham acupuncture for 24 treatments over an 8-week period. Measurements were obtained at baseline and 4 and 8 weeks of treatment; and 3 and 6 months after completion of treatment. The primary outcome was a change in the 24-point Roland Morris Disability Questionnaire scores at the end of treatment. The secondary outcomes included disability, pain intensity, symptoms, and dysfunction. Results: At the end of treatment, mean changes in the Roland Morris Disability Questionnaire were −4.1 (95% CI, −4.9 to −3.3) in the acupuncture group and −1.5 (95% CI, −2.3 to −0.7) in the sham group, with a statistically significant between-group difference: −2.6 (95% CI, −3.7 to −1.4). Acupuncture was superior to sham acupuncture in reducing pain intensity (between-group difference: −2.9 [95% CI, −3.8 to −2.0] in leg and buttock pain, vs −2.3 [95% CI, −3.0 to −1.5] in back pain), symptoms and dysfunction (between-group difference: −0.9 [95% CI, −1.2 to −0.6] in symptom subscale, and −0.8 [95% CI, −1.1 to −0.5] in dysfunction subscale). Conclusions: Acupuncture provides immediate functional recovery and pain relief for degenerative lumbar spinal stenosis. However, current evidence is insufficient to support the suggestion that acupuncture could offer clinical benefits as compared with noninsertive sham acupuncture for degenerative lumbar spinal stenosis. © 2019 Elsevier Inc.