Older patients with chronic low back pain who receive acupuncture treatment have greater improvements in pain and disability compared with patients who receive usual care alone, according to the BackInAction trial.
The results of the study were published online in JAMA Network Open.
BackInAction, an NIH Collaboratory Trial, compared standard and enhanced courses of acupuncture with usual care alone in adults aged 65 years and older with chronic low back pain. Previous studies found acupuncture to be a safe and effective treatment for chronic low back pain in adults, and the American College of Physicians recommends the treatment as first-line therapy. However, few studies, and no large-scale randomized trials, have examined the safety and efficacy of acupuncture in older adults specifically.
“We worked hard to involve adults in multiple regions of the country so that participant demographics were consistent with the US census for older adults,” Lynn DeBar told the NIH. “And we worked with licensed acupuncturists in the community, who are most likely to deliver these services,” she said. DeBar is a senior investigator at the Kaiser Permanente Center for Health Research and a co–principal investigator for BackInAction.
The study team randomly assigned 800 patients to 1 of 3 groups: (1) a standard 12-week course of acupuncture plus usual medical care; (2) standard acupuncture enhanced with 4 to 6 maintenance sessions plus usual care; or (3) usual care alone. The study was conducted in 4 healthcare systems in the Pacific Northwest, Northern California, and New York, including a network of federally qualified health centers in an urban setting, 2 integrated health insurance and care delivery systems serving broad geographic regions, and a fee-for-service system serving a relatively urban and suburban population.
At 6 months and 12 months after treatment, patients in both the standard and enhanced acupuncture groups experienced significantly greater reductions in pain and pain-related disability than patients in the usual care group. The improvements did not differ significantly between the standard and enhanced courses of acupuncture.
“Older adults often are dealing with other medical problems in addition to back pain,” said co–principal investigator Andrea Cook, senior biostatistics investigator at the Kaiser Permanente Washington Health Research Institute. “Acupuncture offers a less invasive option that has a better safety profile than a lot of the common treatments for back pain in older adults,” she said.
BackInAction is supported within the NIH Pragmatic Trials Collaboratory through the NIH HEAL Initiative by a grant from the National Center for Complementary and Integrative Health. Learn more about BackInAction.