As part of the article’s conclusions, the authors stated, “Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk.” ~ Dr. Broussard
October 23, 2024
Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk
TAKE-HOME MESSAGE
- This randomized clinical trial evaluated the efficacy and safety of acupuncture for the treatment of patients with chronic sciatica pain. The primary outcome was a change in visual analog scale score for leg pain. Participants in the acupuncture group had a greater reduction in visual analog scale scores for leg pain than those in the sham acupuncture group, with this benefit persisting at week 52.
- Clinicians should share these findings with patients with chronic pain and advocate for insurance coverage of acupuncture to make this effective and safe treatment accessible to these patients.
IMPORTANCE
Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce.
OBJECTIVE
To investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk.
DESIGN, SETTINGS, AND PARTICIPANTS
This was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk. Participants were recruited from March 25, 2021, to September 23, 2021, with a final follow-up through September 22, 2022. Data analyses were performed from December 2022 to March 2023.
INTERVENTIONS
Participants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded.
MAIN OUTCOMES AND MEASURES
The 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4. Secondary outcomes were adverse events.
RESULTS
A total of 216 patients (mean [SD] age, 51.3 [15.2] years; 147 females [68.1%] and 69 males [31.9%]) were included in the analyses. The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4 (mean difference, -16.0; 95% CI, -21.3 to -10.6; P < .001). The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4 (mean difference, -8.1; 95% CI, -11.1 to -5.1; P < .001). For both VAS and ODI, the between-group difference became apparent starting in week 2 (mean difference, -7.8; 95% CI, -13.0 to -2.5; P = .004 and -5.3; 95% CI, -8.4 to -2.3; P = .001, respectively) and persisted through week 52 (mean difference, -10.8; [95% CI, -16.3 to -5.2; P < .001; and -4.8; 95% CI, -7.8 to -1.7; P = .003, respectively). No serious adverse events occurred.
CONCLUSIONS AND RELEVANCE
This randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52. Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk.