[Objective]The purpose of this study was to compare the effects of superficial and deep insertion of acupuncture needles in the treatment of patients with low back pain and to search for more effective acupuncture methods.
[Methods]A randomized controlled clinical trial was conducted in which 32 patients with low back pain for more than three months of duration were randomly allocated either to a superficial acupuncture group (n = 16) or a deep acupuncture group (n = 16). Treatment was done for the most painful points of the patients. In the superficial insertion group, the needle was only inserted to a depth of 5 mm, whereas in the deep insertion group, the needle was inserted to a depth of about 20 mm, and was manually stimulated (sparrow pecking method) for 20 seconds. Both groups were treated weekly for four weeks. The visual analog scale (VAS) of pain, Roland-Morris Disability Questionnaire (RDQ), and Pain Disability Assessment Scale (PDAS) were used for outcome measurement.
[Result]VAS, RDQ and PDAS scores showed significant differences between groups (VAS:p < 0.05, RDQ:p <0.001, PDAS:p < 0.05) in change over time with the deep insertion group having more favorable results than the superficial insertion group. The degree of change from the baseline at the time of each evaluation was calculated and results for the two groups were compared. The deep insertion group was significantly better in tendency to improve directly after the first treatment (p < 0.01), in cumulative effect after repeated treatment (VAS:p = 0.13, RDQ:p < 0.05, PDAS:p < 0.01), and in sustained effect after completion of treatment (VAS:p < 0.05, RDQ:p < 0.01, PDAS:p <0.05).
[Discussion and Conclusion]The study showed that deep stimulation is a more effective treatment than superficial stimulation. It is thought that the differences of the effects are due to different influences of the treatments on the pain threshold, muscle blood flow, and muscle tones.

[Objective]To investigate whether acupuncture is effective to prevent fatigue and oxidative stress in distance runners.
[Methods]A total of 17 runners were recruited and randomized to receive acupuncture (Press Tack Needle) or placebo treatment. Subjects received treatment from licensed acupuncturists before a 10 km race. The primary outcome measures were oxidative stress, as determined by electron spin resonance (ESR), and fatigue, as assessed using the Visual Analogue Scale (VAS). Secondary outcome measures were GOT, LDH, and CPK.
[Results]Fatigue was significantly increased in both groups after the race. There was no difference in both groups.
Hydroxyl radical scavenging activity tended to increase in both groups after the race.
[Conclusion]The study found no useful acupuncture aspects of oxidative stress and fatigue.

[Objective] The purpose of this cross-sectional questionnaire-based study is to investigate the challenges of adverse events during treatment by acupuncture and moxibustion to an athlete. [Methods] In total, 1,804 subjects, including athletes who participated in marathons and university athletes were enrolled in this study. The survey was conducted by distributing the questionnaire or via online questionnaire to the athletes who fit the criteria for the study. The questionnaires were collected after consent was received from the participants; online questionnaires were also collected. The questionnaire was examined for age, sex, and type of competition, purpose of the acupuncture treatment and the actual effects, and treated area, content of adverse event, number of times the subjects received acupuncture, and informed consent, and free description of adverse events.[Results] In total, 1,525 (84.5%) valid responses to the questionnaires were received. The survey analyzed 841 subjects (55.1%) who experienced acupuncture and moxibustion. The following responses about adverse events of acupuncture were obtained: "pain at time of needle insertion"; 17.0%, "subcutaneous-bleeding"; 10.1% and "pain and feeling of heaviness due to the needle": 10.0%, among others. For moxibustion, responses included "burns"; 5.9% and "malaise"; 5.8%, among others. In the free description, there were 17 descriptions of discomfort due to excessive stimulation and difficulty in movement during exercise. Of the questions regarding whether or not they received informed consent, 215 were received orally (25.6%), 34 were received in written form (4.0%), 99 were received both orally and in written form (11.8%).[Discussion and Conclusion] Acupuncture for athletes causes a certain rate of adverse events. It was suggested that guidelines for athletes to receive acupuncture safely and training and education for practitioners are important.