The effects of acupuncture and moxibustion on lower back pain in clinical trials were reviewed. First, the effects of Western medicine on lower back pain, patients with specific and nonspecific lower back pain, were systematically reviewed based on online data, and possible mechanisms were discussed. Secondly, the role and potential of acupuncture and moxibustion on lower back pain were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on several kinds of lower back pain was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be more effective on non-specific lower back pain.

In recent years, due to the rapid changing social structure, thedemands for medical services are also changing. There is a need to explore the future direction of acupuncture and moxibustion. Therefore, using the keyword "patient"as the focus of medicalservices, we discussed the question, "What is meant by 'patient-centered'Acupuncture and Moxibustion?"
Our results indicate that the numerous clinical treatments, education, and research that occurred throughout the long history of acupuncture and moxibustion in Japan were in fact all done "for the patient."However, we note that there is still room for improvement in verification method and cooperation between each field, and we confirmed that there is a need to build Acupuncture and Moxibustion methods that truly represent "patient-centered medicine."

[Objective]Acupuncture has been reported to be useful for temporomandibular disorders. There have been many reports on muscle problems in temporomandibular disorders (TMD) but only a few reports on disc problems. We report on the use of acupuncture in a temporomandibular disorder patient with disc disorders.
[Case]A 19-year-old female complained of pain upon opening her mouth and trismus. We applied acupuncture with the aim of resolving the disc problems and providing analgesia by a contributing muscle needling approach.
[Methods]The following were measured:intensity of jaw pain, anxiety and satisfaction (visual analogue scale:VAS), position and form of disc and caput mandibulae (MRI) and presence of jaw deviation.
[Results]The following were improved after acupuncture treatments:intensity of jaw pain, anxiety and satisfaction, limitation of jaw movement and jaw deviation. However, the positions of the discs did not change.
[Conclusion]These results suggest that acupuncture may be effective for temporomandibular disorder patients with disc disorders.

[Objective]To compare the efficacies of three types of acupuncture modalities on the pain magnitude and disability of chronic low back pain (LBP).
[Design]Single blind randomized controlled trial, three parallel arms.
[Setting]Outpatients of the Meiji University of Integrative Medicine Hospital.
[Subjects]Thirty-nine elderly patients (24 females, 15 males;age 71.2 ± 7.7) who suffered from LBP for at least six months.
[Interventions]Subjects were randomly allocated to one of three groups. Tender point group (TeP, n = 13) received to the tender point. Trigger point acupuncture group (TrP, n = 13) received to the trigger points. Sham acupuncture group (SM, n = 13) mimicked needling without insertion of the needle in the trigger point. Acupuncture sessions were performed once a week for five weeks.
[Main Outcome Measures]Pain intensity (visual analogue scale:VAS) and QOL (Roland-Morris Disability Questionnaire:RDQ).
[Results]At the end of the treatment period, significant improvement was observed on pain intensity and QOL in the TrP group alone (p < 0.01). However, there were significant differences in pain at the three month follow-up.
[Conclusion]These results suggest that trigger point acupuncture has a long-term effect on treatment for low back pain in aged patients.

[Objective]To evaluate the efficacy of the different depth of acupuncture on the motor function and the pain with osteoarthritis of the knee.
[Design]Single blind randomized controlled trial.
[Method]Subjects were randomly allocated to one of two groups. Acupuncture needles were inserted about 3mm in the superficial acupuncture group and 10 to 20 mm in the deep acupuncture group. Subjects in both groups received the treatments for ten minutes on ten tender points. Acupuncture sessions were performed once a week for 8 weeks and without treatment 4 weeks.
[Outcome Measures]Pain intensity (visual analogue scale :VAS) , Objective evaluation of the motor function (Timed Up &Go test, 20m walking time, Time of going up and down stairs) and QOL (Western Ontario and MacMaster Universities osteoarthritis index :WOMAC).
All measurements were recorded at baseline, 4th, 8th and 11thweek.
[Result]Motor function improved significantly only in the superficial acupuncture group(P<0.05). The degree of pain decreased significantly in both groups (P<0.05).
[Conclusion]Superficial acupuncture provided the improvements on pain and motor function and contributed to the QOL improvement. Therefore the superficial acupuncture would be suggested to be one of the most effective method for the acupuncture treatment of OA of the knee.

[Objective] Although there is some evidence for the efficacy of trigger point acupuncture and tender point acupuncture treatments for chronic low back pain, differences between the therapeutic effect of trigger point needling and that of tender point needling remain unclear. We compared the therapeutic effects of trigger point acupuncture and tender point acupuncture treatment for chronic low pack pain in elderly patients.
[Design] Single-blind clinical controlled trial, quasi-randomized, 2 parallel arms.
[Methods] Nine patients, aged 65 or over, with chronic low back pain for at least 6 months were alternately allocated to the trigger point needling group (n=4) or tender point needling group (n=5). Patients received treatments once a week for five weeks. Outcome measures were pain intensity (Visual Analog Scale : VAS) and pain disability (Roland-Morris Disability Questionnaire : RDQ).
[Results] After the treatment period, VAS and RDQ values had improved significantly in the trigger point group, but there were no significant improvements in the tender point group.
[Conclusion] Differences in improvement between the trigger point and tender point groups seem to suggest that the trigger point needling was different from tender meridian point needling in respect to the therapeutic effect. Further studies are necessary to fully assess the efficacy of this treatment for chronic low back pain using a blinded or placebo control group.

Effects of acupuncture and moxibustion on chronic pain in human and animals were reviewed. Firstly, the role of sensitization of pheripheral and/or central nervous systems on the mechanisms of chronic pain was introduced based on the basic researches in experimental animals. Secondly, the effects of acupuncture on neuropathic pain and postoperative pain patients were reviewed and its possiblemechanisms were discussed. Finally, effectiveness of acupuncture and moxibustion on several kinds of chronic nociceptive pain (low back pain, neck pain, headache) was systematically reviewed based on the online database

[Purpose] This study investigated shoulder stiffness in university students and compared three different treatment procedures for shoulder stiffness.
[Method] The questionnaire (7 items) was distributed to 30 university students with a 3-month history of shoulder stiffness treated by three different treatments procedures. There were no abnormal findings on neuro logical examination.
[Result] The questionnaire response rate was 64.6%. The overall prevalence of shoulder stiffness was 61.9%, most patients had asthenopia and headache along with shoulder stiffness. However, immediately after the tender point and sham treatment periods, there were no remarkable clinical effect on shoulder stiffness, whereas after trigger point treatment, there were remarkable clinical effects on shoulder stiffness, as evaluated by the visual analogue scale.
[Conclusion] These results suggest that trigger point acupuncture treatment may be more effective for shoul- der stiffness in university students than other acupuncture treatments

[Purpose] This study investigated sports injuries in university students and compared two different acupuncture therapy procedures for chronic low back pain (LBP).
[Method] The questionnaire (12 items) was distributed to members of sports clubs at Meiji University of Oriental Medicine. Patients with LBP resulting from sports injuries who had had low back pain for more than a year were treated by two different acupuncture therapy procedures. There were no abnormal findings in their neurological examinations.
[Result] The questionnaire response rate was 68.6%. The overall prevalence rate of sports injuries was 77.6%, and LBP patients were the most common. On the other hand, during and after the preceding therapy, using the traditional acupoints for LBP, there was no remarkable clinical effect on LBP, whereas during and after the succeeding therapy using the trigger point, there were remarkable clinical effects on LBP, as evaluated by the visual analogue scale.
[Conclusion] These results suggest that trigger point acupuncture therapy may be more effective on chronic LBP in sports than therapy which uses traditional acupuncture.