Acupuncture for Lumbar Spinal Stenosis: Efficacy and Insights
Acupuncture for Neurogenic Claudication in Degenerative Lumbar Spinal Stenosis: A Summary
Acupuncture has been explored as a treatment option for various conditions, including degenerative lumbar spinal stenosis (DLSS). A recent 2024 study published in the Annals of Internal Medicine investigates the effectiveness of acupuncture in relieving pain-specific disability among patients with DLSS and neurogenic claudication pain symptoms.
Key Points
Improvement in Disability Scores: Acupuncture showed significant improvements in modified Roland-Morris Disability Questionnaire scores compared to sham acupuncture.
Clinically Meaningful Improvement: More participants in the acupuncture group achieved minimal and substantial clinically meaningful improvements.
Long-term Benefits: The effects of acupuncture were observed to last up to 24 weeks after the treatment.
Safety: Mild and transient treatment-related adverse events were reported equally in both acupuncture and sham acupuncture groups.
Further Research Needed: More studies are required to explore acupuncture's impact on walking capacity and using non-penetration needling as a sham control.
Study Design and Methodology
The study was conducted across five hospitals in China and involved 196 participants diagnosed with DLSS and predominantly neurogenic claudication pain symptoms. Participants were randomly assigned to either acupuncture or sham acupuncture (SA) groups, with 98 patients in each group. Over six weeks, the patients received 18 sessions of acupuncture or SA. The primary outcome was the change in the modified Roland-Morris Disability Questionnaire (RMDQ) scores, a measure of disability due to low back pain. Secondary outcomes included the proportion of participants achieving minimal and substantial clinically meaningful improvements.
Results
At the baseline, the mean modified RMDQ scores were similar in both groups (12.6 for acupuncture and 12.7 for SA). After six weeks, the scores decreased to 8.1 in the acupuncture group and 9.5 in the SA group, with an adjusted difference in mean change of -1.3, indicating a 43.3% greater improvement for acupuncture. Additionally, 16.0% more participants in the acupuncture group achieved minimal clinically meaningful improvement, and 12.6% more achieved substantial improvement compared to the SA group. These results suggest that acupuncture may effectively reduce pain-specific disability in DLSS patients.
Study Limitations and Future Research
While the findings are promising, the study had some limitations. The use of SA, which could produce physiologic effects, might have influenced the results. Additionally, the fixed acupuncture protocol limited personalization of treatments, and the follow-up period was only 24 weeks after treatment. Future research should focus on the long-term effects of acupuncture, its impact on walking capacity, and using non-penetration needling as a more rigorous sham control.
Implications for DLSS Treatment
This study highlights acupuncture's potential as an effective complementary treatment for managing pain-specific disability in patients with DLSS. While the results did not reach the minimal clinically important difference (MCID) compared to SA, the significant improvements observed suggest that acupuncture can be a valuable part of a comprehensive treatment plan. As more research supports its efficacy, acupuncture may become more widely integrated into standard care practices for DLSS.
Conclusion
Acupuncture may offer a promising non-surgical treatment option for managing pain-specific disability in patients with degenerative lumbar spinal stenosis. With a growing body of evidence supporting its benefits, acupuncture could play an essential role in comprehensive care for DLSS, enhancing patient outcomes and quality of life.
Over to you
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Sources:
Zhu, L., Sun, Y., Kang, J., Liang, J., Su, T., Fu, W., ... & Liu, Z. (2024). Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis: A Randomized Clinical Trial. Annals of Internal Medicine. Advance online publication. https://doi.org/10.7326/M23-2749
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