Acupoint Specificity To Analgesic Effect Of Wrist-ankle Acupuncture For Low Back Pain:a Randomized Controlled Trial

Objective: To test the theory of “choosing wrist-ankle acupuncture(WAA)needling point based on the WAA partition of the body”,which means whether the corresponding relationship of needling point and partition of the body is specific,that is,the specificity of needling point.Design: A randomized controlled trial.Setting: Out-patient Clinic,Department of Acupuncture and Massage,Changhai Hospital,Second Military Medical University,Shanghai,China.Participants: Ninety adults aged 20-64 years with acute low back pain(ALBP)of 1-82 days duration were randomly assigned to a specific acupuncture point group(termed SA)and two non-specific acupuncture point groups(termed NSA1 and NSA2)according to 1:1:1 ratio,with 30 patients in each.Interventions: In the patients of the SA group,needles were inserted subcutaneously into the acupoints of Lower 5 or 6,while in the patients of the NSA1 and NSA2 groups,needles were inserted subcutaneously into the acupoints of Lower 2 and Upper 5,respectively.All patients were administered with one treatment,with needles retained for 30 minutes.Outcome Measures: Short-form Mc Gill pain questionnaire(SF-MPQ)and modified-modified Schober test(MMS)were used to assess motion-related pain and changes of spinal flexion at 3 minutes before treatment and at the 5-,10-,15-,and 30-min time points in the course of treatment,respectively.Expectation and Treatment Credibility Scale(ETCS)was used to analyze the relationship between the expectation of patients and the analgesic effect.Meanwhile,side effect of WAA was recorded.Results: There were no statistically significant differences in the scores of SF-MPQ,MMS and ETCS before treatment in all the three groups(P>0.05).At the 5-,10-,15-,and 30-min time points,the scores of all the items of SF-MPQ in all the three groups were lower than pretreatment(P<0.05).At the 5-,10-,and 15-min time points,the differences of the scores of all the items of SF-MPQ(except PPI)between these time points and pretreatment in the SA group were greater than those in the NSA1 and NSA2 groups(P<0.05).After 30-minute acupuncture,the differences of the scores of all the items of SF-MPQ between this time point and pretreatment in the SA group were greater than those in the NSA1 and NSA2 groups(P<0.05).After 30-minute acupuncture,the scores of MMS in all the three groups were lower than pretreatment(P<0.05),and the difference of the score of MMS between this time point and pretreatment in the SA group was greater than that in the NSA1 and NSA2 groups(P<0.05).After 30-minute acupuncture,the scores of all the items of ETCS in the SA group were higher than pretreatment(P<0.05),while such a difference was not observed in the NSA1 and NSA2 groups.No side effects were reported.Conclusions: Both the specific acupuncture in Lower 5 or 6 by WAA and the non-specific acupunctures in Lower2 and Upper 5 by WAA can reduce the acute low back pain and improve the range of lumbar flexion to a certain extent,while the effects of the specific acupuncture are better than the non-specific acupunctures.Trial Registration Number: Chi CTR-IOR-15007136.