OBJECTIVE: Several kinds of steroids had been used epidurally for the treatment of low back pain, but there were few available medical reports as to the effects of each steroid. The purposes of this study were to evaluate the effects of epidural steroid injections and to investigate the factors affecting the results. METHOD: Forty four backache patients were randomly assigned to one of three groups: Group 1, epidural saline as a control group(n=12); Group 2, epidural triamcinolone and 1% lidocaine(n=13); Group 3, epidural dexamethasone and 1% lidocaine(n=19). The effects of epidural injections were measured by pain self-assessment scale(pain score) and Rubin scale(success rate). RESULTS: The pain scores of steroid groups after one to seven days after the injections were significantly lower than those of the control group(p<0.05), but there were no statistical differences(p>0.05) between two steroid groups. The overall success rate of the steroid groups was 68.8%. Although there were no statistically significant differences between the steroid groups with respect to sex, age and duration, the younger age group seemed to respond better to the treatment. CONCLUSION: We founded that epidural steroid injection could be a valuable adjunct to the management of low back pain but its effective duration was relatively short. Physicians should keep in mind that comprehensive treatment including rest, medication, physical therapy, exercise and education ought to be provided for the better clinical results.
Back Pain ; Dexamethasone ; Education ; Exercise Therapy ; Humans ; Injections, Epidural ; Low Back Pain* ; Self-Assessment ; Steroids ; Triamcinolone

BACKGROUND: Beginning with the concepts of stress developed by Selye, an approach to stress and pain management, known as neuro-emotional technique (NET), has been developed. It is a treatment approach based on the principle that the stressor effects of dormant and/or current unresolved issues or trauma are what determine one's bodily responses. These responses are relatively personalized to the conditioned, experiential and emotional reality of the individual. OBJECTIVE: To determine the effect of NET on patients with chronic low back pain (CLBP) over time. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: In a randomized, double-blinded, placebo-controlled study conducted in a single clinic, NET or control treatments were given twice weekly for 4 weeks in a population of 112 patients. MAIN OUTCOME MEASURES: Outcome measures, including Oswestry Disability Index, Quadruple Visual Analogue Scale, the psychoneuroimmunology markers of blood serum levels of C-reactive protein, tumour necrosis factor-α, interleukin-1 (IL-1), IL-6, and IL-10, and 10 dimensions of the Short Form Health Survey scale, were assessed at baseline and at 1, 3 and 6 months following the intervention period. RESULTS: Compared to placebo, NET produced clinical and statistical significance (P < 0.001) via declines of virtually all physiological, pain and disability markers, accompanied by gains in quality-of-life indicators at 0 (baseline), 1, 3 and 6 months. Reductions of the percentages of patients whose 5 biomarkers lay outside the normative range were achieved at 1, 3 and 6 months by NET but not control interventions. CONCLUSION: A randomized, controlled trial of CLBP patients indicated that 8 NET interventions, compared to placebo, produced clinically and statistically significant reductions in pain, disability and inflammatory biomarkers, and improvements in quality-of-life measures. TRIAL REGISTRATION The trial was registered with the Australian and New Zealand Clinical Trials Registry (No. ACTRN12608000002381).
Australia ; Chronic Pain/therapy* ; Double-Blind Method ; Humans ; Low Back Pain/therapy* ; Pain Measurement ; Treatment Outcome

Acupuncture is a promising treatment for relieving pain and improving lower back function in clinical practice. However, evidence from randomized clinical trials (RCTs) remains controversial. Most RCTs conclude that acupuncture procedures for chronic low back pain (CLBP) had no significant difference in efficacy and belonged to placebo. We carefully reviewed and analyzed the methodology and implementation of sham acupuncture in RCTs. Controversial evidence of acupuncture for CLBP is only a microcosm of the evaluation methodological limitation of acupuncture. Inappropriate selection of sham acupuncture controls, rigorous RCT research models, and incorrect interpretation of results may contribute to negative evidence. Evaluating and disregarding the holistic efficacy of acupuncture with an explanatory RCT model based on evaluation drugs may be unwise. Moreover, sham acupuncture is often proven to be non-inert, unreasonable, and with low fidelity. Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided. Establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.
Acupuncture Therapy ; Chronic Pain/therapy* ; Humans ; Low Back Pain/therapy* ; Randomized Controlled Trials as Topic ; Treatment Outcome

OBJECTIVE: To compare the differences in the clinical therapeutic effects on chronic non-specific low back pain (CNLBP) between the combined treatment of the superficial needling technique and mild moxibustion and the traditional warm acupuncture. METHODS: A total of 60 patients were randomized into a combined treatment group and a warm acupuncture group, 30 cases in each one. In the combined treatment group, the superficial needling technique was used in combination with the mild moxibustion with moxa box at the muscle region of the bladder meridian on the back. In the warm acupuncture group, the traditional warm acupuncture was adopted on the lumbar region and the upper back. Each treatment lasted 30 min, 3 times a week. The treatment was provided continuously for 3 weeks. The follow-up visit lasted 3 months. Separately, before, 3 times after treatment and at the end of treatment, as well as after the follow-up visit, the visual analogue scale (VAS), the range of motion of the lumbar region (ROM) and the Oswestry disability index (ODI) were observed in the patients of the two groups. RESULTS: During and at the end of treatment, as well as at the follow-up visit, VAS score, ROM and ODI were all improved as compared with those before treatment in the two groups (all <0.05). The results in the combined treatment group were better than those in the warm acupuncture (all <0.05). At the end of treatment and the follow-up stage, VAS score, ROM and ODI were better than those during treatment in the two groups (all <0.05). At the follow-up stage, VAS score, ROM of the backward extension and rotation of spine, as well as ODI were better than those at the end of treatment in the two groups (all <0.05). CONCLUSION The combined treatment of the superficial needling technique and mild moxibustion relieves pain, improves the ROM of the lumbar region and reduces the functional disability in CNLBP. This combined therapy achieves the better effects as compared with the traditional warm acupuncture and is high in the patient's compliance.
Acupuncture Points ; Acupuncture Therapy ; Chronic Pain ; therapy ; Humans ; Low Back Pain ; therapy ; Moxibustion ; Treatment Outcome

OBJECTIVE: To assess the efficacy and safety of Bushen Huoxue Formula (BSHXF) for the treatment of discogenic low-back pain (DLBP). METHODS: This was a parallel, double-blind, randomized, clinical trial performed between May 2019 and June 2020. Seventy patients were assigned by computerized random number table to the treatment group (lumbar traction and BSHXF, 35 cases) or the control group (lumbar traction and placebo, 35 cases). The patients received intervention for 3 weeks. Assessment was conducted before treatment and at week 1, 2, 3 during treatment. Primary outcome was the self-reported score of Oswestry Disability Index (ODI). Secondary outcomes included Visual Analog Scale (VAS), clinical efficacy rate by minimal clinically important difference (MCID) as well as lumbar tenderness, muscle tone and lumbar spine mobility. Adverse reactions were recorded. Follow-up was performed at 1 and 3 months after the end of treatment. RESULTS: In the treatment group, ODI score was significantly decreased compared with baseline (P<0.05) and the control group at 2- and 3- week treatment. Similarly, VAS score decreased compared with the baseline (P<0.05) and was lower than that in the control group at 2- and 3- week treatment (P<0.05). The clinical efficacy rate of the treatment group was higher than that of the control group after treatment [32.35% (11/34) vs. 3.13% (1/32), P<0.05). Moreover, the tenderness, and muscle tone, as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group (P<0.05). Follow-up showed that at 1-month after treatment, the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores, as well as clinical efficacy rate (all P<0.05). Moreover, VAS score was still significantly lower than the control group at 3-month follow-up (P<0.05). No adverse reactions were reported during the study. CONCLUSION BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity, functionality, muscle tone, and lumbar spine mobility in DLBP patients. (Registration No. ChiCTR1900027777).
Humans ; Intervertebral Disc Degeneration/therapy* ; Low Back Pain/drug therapy* ; Lumbar Vertebrae ; Pain Measurement ; Treatment Outcome

OBJECTIVE: To observe the effect of acupuncture combined with suspension exercise therapy on the clinical symptoms, lumbar proprioception and trunk isokinetic muscle strength in patients with chronic low back pain. METHODS: A total of 100 patients with chronic low back pain were randomly divided into an observation group and a control group, 50 cases in each group. The patients in the control group were treated with suspension exercise therapy, and the training exercise was selected according to the patient's exercise ability, the suspension exercise therapy was given once a day, three times a week, for totally 4 weeks. Based on the treatment of the control group, the patients in the observation group were treated with acupuncture at Dachangshu (BL 25), Weizhong (BL 40), Qihaishu (BL 24), Shenshu (BL 23) and points, the acupuncture was given once a day, six times as a course of treatment, and a total of two courses of treatment were given. Before and after treatment, the scores of symptoms and signs, the pain rating index (PRI), present pain intensity (PPI) and the visual analogue scale (VAS) in the short-form of McGill pain questionnaire (SF-MPQ) in the two groups were recorded. The isokinetic feedback biomechanical test system was used to measure the lumbar proprioception and isokinetic muscle strength of the trunk, and the clinical efficacy of the two groups was evaluated. RESULTS: The scores of symptoms and signs, PRI, PPI and VAS after treatment were lower than those before treatment in the two groups (<0.05), and those in the observation group were lower than those in the control group (<0.05). The absolute error angle (AE) of lumbar proprioceptive index in the flexion and extension positions after treatment was lower than that before treatment in the two groups (<0.05), and that in the observation group was lower than that in the control group (<0.05). After treatment, the peak torque (PT) of musculus flexor and musculus extensor as well as peak torque/body weight (PT/BW) of musculus extensor were increased in the two groups, and the flexor/extensor (F/E) was reduced (<0.05). The PT of musculus flexor and musculus extensor as well as PT/BW of musculus extensor in the observation group were higher than those in the control group (<0.05), and F/E was lower than that in the control group (<0.05). The total effective rate was 90.0% (45/50) in the observation group, which was higher than 76.0% (38/50) in the control group (<0.05). CONCLUSION The acupuncture combined with suspension exercise therapy could effectively improve the symptoms and signs of patients with chronic low back pain, enhance the lumbar proprioception and trunk isokinetic muscle strength.
Acupuncture Points ; Acupuncture Therapy ; Combined Modality Therapy ; Exercise Therapy ; Humans ; Low Back Pain ; therapy ; Treatment Outcome

OBJECTIVE: To evaluate the short and medium effect of peripheral repetitive magnetic stimulation therapy on chronic low back pain compared with transcutaneous electrical nerve stimulation therapy. METHOD: Twenty-three subjects with chronic low back pain were allocated randomly to repetitive magnetic stimulation group (n=13) and transcutaneous electrical nerve stimulation group (n=10). Each treatment consisted of 10-minutes sessions each day, totally 10 sessions over 2 weeks. Subjects were evaluated pre-treatment and post-treatment at 8 hours and 2 weeks. Outcome was measured with the Oswestry disability index, McGill pain questionnaire, and daily mean pain numeric rating scale. RESULTS: At 8 hours and 2 weeks post-treatment, transcutaneous electrical nerve stimulation therapy group showed a significant improvement in the mean pain numeric rating scale. Two weeks post-treatment, transcutaneous electrical nerve stimulation therapy group showed a significant improvement in the Oswestry disability index. But there were no significant therapeutic effect of repetitive magnetic stimulation therapy group at all period. CONCLUSION: This study showed that repetitive magnetic stimulation therapy may be less effective than transcutaneous electrical nerve stimulation therapy for the treatment of chronic low back pain.
Low Back Pain ; Magnetic Field Therapy ; Magnetics ; Magnets ; Pain Measurement ; Pilot Projects ; Transcutaneous Electric Nerve Stimulation

OBJECTIVE: To observe the effect of " Acupuncture" on postpartum low back pain. METHODS: A total of 98 cases of postpartum low back pain were randomly divided into a control group (45 cases, 4 cases dropping) and a treatment group (47 cases, 2 cases dropping). Conventional acupuncture was treated in the control group, and " Acupuncture" was added in the treatment group on the basis treatment in the control group, acupuncture was applied at Baihui (GV 20), Neiguan (PC 6), Taichong (LR 3). The treatment was given 30 minutes each time, 5 times a week, 10 times for a total course of treatment. Before and after treatment, pain was assessed by the short-form of McGill pain questionnaire (SF-MPQ), dysfunction was assessed by Oswestry disability index (ODI), and depression was assessed by the Edinburgh postnatal depression scale (EPDS). And the changes of various indexs were observed before and after treatment. RESULTS: After treatment, the pain grade index (PRI) score, visual analog scale (VAS) score and present pain intensity (PPI) score in SF-MPQ of the control group and the treatment group were significantly lower than those before treatment (all <0.001). The ODI score and EPDS score were also significantly lower than those before treatment (all <0.001). The decline scores of the treatment group before and after treatment were significantly higher than those in the control group (<0.001, <0.01). CONCLUSION " Acupuncture" combined with conventional acupuncture and conventional acupuncture can effectively improve the symptoms of pain, dysfunction and depression in patients with postpartum low back pain, and the former is significantly better than the latter.
Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Low Back Pain ; Pain Measurement ; Postpartum Period ; Treatment Outcome

OBJECTIVE: To compare the therapeutic effect between Fanzhen Jieci (warming acupuncture plus fast needling) combined with conventional acupuncture and simple conventional acupuncture on discogenic sciatica. METHODS: A total of 76 patients with discogenic sciatica were randomized into a Fanzhen Jieci group and a conventional acupuncture group, 38 cases in each one. Conventional acupuncture was applied at Shenshu (BL 23), Dachangshu (BL 25), L₁-L₅ Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side, etc. in the conventional acupuncture group. On the basis of the treatment in the conventional acupuncture group, Fanzhen Jieci was applied at L₁-L₅ Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side in the Fanzhen Jieci group, i.e. warming acupuncture was applied at L₁-L₅ Jiaji (EX-B 2), and fast needling was applied at Huantiao (GB 30) on the affected side for a depth of 40-60 mm, so as to introduce a sensation of electric shock transmitting to lower limb, and then the needle was immediately withdrawn. The treatment was given once every other day, 3 times a week for 3 weeks in both groups. The visual analogue scale (VAS) score of leg and low back pain, the Oswestry disability index (ODI) score and the 36-item short form health survey (SF-36) score before and after treatment were compared between the two groups. RESULTS: Compared before treatment, the VAS scores of leg and low back pain and the ODI scores after treatment were decreased in both groups (P<0.001), the changes of the VAS scores of leg and low back pain in the Fanzhen Jieci group were larger than those in the conventional acupuncture group (P<0.05). After treatment, except for the role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the Fanzhen Jieci group (P<0.01); except for the role physical, role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the conventional acupuncture group (P<0.01). After treatment, the physical functioning, role physical, bodily pain, mental health and general health scores of SF-36 in the Fanzhen Jieci group were higher than those in the conventional acupuncture group (P<0.05). CONCLUSION Fanzhen Jieci combined with conventional acupuncture can effectively relieve the pain and improve the mental state in patients with discogenic sciatica, its therapeutic effect is superior to simple conventional acupuncture.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Low Back Pain/therapy* ; Sciatica/therapy* ; Treatment Outcome

OBJECTIVE: To compare the clinical effect between head acupuncture combined with exercise therapy and conventional acupuncture for nonspecific low back pain. METHODS: A total of 64 patients with nonspecific low back pain were randomized into an observation group (32 cases, 2 cases dropped off) and a control group (32 cases, 2 cases dropped off). In the control group, conventional acupuncture was applied at Jiaji (EX-B 2) of L₁ to L₃, ashi point, Shenshu (BL 23), Dachangshu (BL 25), Yaoyangguan (GV 3) and Weizhong (BL 40). The observation group was treated with head acupuncture combined with exercise therapy, head acupuncture was applied at foot-motor-sensory area on the healthy side and Cuanzhu (BL 2), Tongziliao (GB 1) on the affected side, and McKenzie therapy was performed during retention. The needles were retained for 40 min, once a day, continuous treatment for 6 days with the interval of 1 day, 14 days were required in the two groups. Before and after treatment, the pain visual analogue scale (VAS) score, Oswestry disability index (ODI) score and infrared thermography temperature of pain area in the low back were compared in the two groups. RESULTS: Compared before treatment, the VAS and ODI scores after treatment were decreased in the two groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). Compared before treatment, the infrared thermography temperature of pain area in the low back after treatment was increased in the two groups (P<0.01), and that in the observation group was higher than the control group (P<0.01). CONCLUSION Head acupuncture combined with exercise therapy could relieve pain, improve dysfunction and increase the local temperature of pain area in patients with nonspecific low back pain, and its curative effect is better than conventional acupuncture.
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Exercise Therapy ; Humans ; Low Back Pain/therapy* ; Treatment Outcome