Acupressure trumps physical therapy for low back pain

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Biomechanics April 2006

http://biomech.com/showArticle.jhtml?articleID=185302962

Acupressure trumps physical therapy for low back pain

By: Lori Rochelle Roniger

Acupressure may be significantly more effective than physical therapy

at reducing the levels of pain and disability experienced by chronic

low back pain patients, according to a study conducted by researchers

at National Taiwan University in Taipei.

Acupressure is a discipline of traditional Chinese medicine that

involves the application of pressure, typically using the hands, on

specific points on the body, based on the same meridian points as

acupuncture.

No previous randomized controlled trials have addressed functional

status and disability following acupressure treatment for low back

pain, according to the authors.

Subjects for the study were 129 orthopedic specialty clinic

outpatients between the ages of 18 and 81 who had suffered from

chronic low back pain, as diagnosed by a senior orthopedic

specialist, for more than four months.

The subjects were slated to receive six treatment sessions within one

month, with 64 patients randomly assigned to acupressure treatment

and 65 to physical therapy.

The acupressure patients each were treated by the same senior

acupressure therapist. The physical therapy was that routinely

offered by the clinic and included pelvic manual traction, spinal

manipulation, thermotherapy, infrared light therapy, electrical

stimulation, and exercise therapy. The acupressure therapist and

physical therapists were blinded to the pretreatment assessments of

their patients.

Study subjects filled out questionnaires or were interviewed by

telephone prior to treatment, immediately after the completion of six

treatment sessions or one month (whichever was earlier), and after

six months. Their pain and disability levels were assessed using a

visual analog scale, the Roland and disability questionnaire,

the Modified Oswestry Disability Questionnaire, and core outcome

measures. The interviewer was blinded to subjects' pretreatment

assessments and was instructed not to ask subjects about their

treatments.

The acupressure group indicated significantly lower levels of

disability on the Roland and questionnaire after both one

month and six months compared to the physical therapy group. The

difference in absolute score or mean change from baseline had no

effect on the significance of the results, the researchers reported

in their article, which was published in February by BMJ Online

First. The significance of these results remained even after

adjusting for pretreatment scores, disability levels, and other

baseline characteristics.

Additionally, sleep disturbance and mean scores on the VAS were

significantly lower in the acupressure group than in the physical

therapy group after both one and six months. These results also

remained significantly different after adjusting for pretreatment

scores and baseline characteristics.

After adjusting for pretreatment scores, significant differences

between the two groups were found after one month and six months for

degree of bothersomeness of low back pain, leg pain, and the

interference of pain with normal work, and for " satisfaction of life

with symptoms, " days during which patients did fewer things, days

during which patients took off from work or school, and satisfaction

with previous pain treatment.

The Oswestry questionnaire results also showed significantly lower

levels of disability in the acupressure group after both one and six

months, regardless of the difference in absolute score or mean change

from baseline, with the changes remaining significant after adjusting

for pretreatment scores or disability and other baseline

characteristics.

" This trial has shown the efficacy of acupressure compared with

physical therapy in pain relief for patients with low back pain in

terms of disability, pain scores, and functional status, " the authors

concluded. " The results provide a basis for comparison across

international studies. "