Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis assess the effectiveness of acupuncture as an adjunct to standard therapy in the management of nonspecific chronic low back pain (NScLBP), compared with standard therapy alone. Methods: A systematic literature search of full-text articles of randomized controlled trials in the date range of 2000–2020, utilizing PubMed and EBSCO databases, was performed to evaluate the efficacy of acupuncture treatment for nonspecific chronic lower back pain. The outcomes of interest were pain intensity and disability. The methodological quality of each study was evaluated using Cochrane risk-of-bias criteria. The studies were combined using meta-analysis when statistical pooling of data was possible. Results: This systematic review included 5 studies of which 4 were included in the meta-analysis. Acupuncture as an adjunct to standard therapy had clinically meaningful reduction in self-reported pain at post-treatment (mean difference = −1.04 [95% confidence interval (CI), −1.59 to −0.49], P < 0.001, I2 = 46.1%) and at intermediate term (mean difference = −0.82 [95% CI, −1.13 to −0.50], P < 0.001, I2 = 0%), compared with standard care. Levels of disability showed similar clinically meaningful reduction at post-treatment and intermediate term. Conclusion: Both the systematic review and meta-analysis demonstrate that acupuncture as an adjunct to standard therapy is a safe and effective method in reducing pain and disability among adults with NScLBP.