Acupuncture Beats Sham for Sciatica Pain

TOPLINE:
Acupuncture significantly reduced leg pain and disability in chronic sciatica patients compared with sham acupuncture. Benefits persisted through 52 weeks, with no serious adverse events reported.
METHODOLOGY:
A total of 216 patients with chronic sciatica from herniated disk were included in the trial and were randomly assigned to receive 10 sessions of acupuncture or sham acupuncture over 4 weeks.
The study was conducted at six tertiary hospitals in China, with follow-up assessments at weeks 2, 4, 8, 26, and 52.
The primary outcomes were changes in leg pain intensity and disability, measured by the visual analog scale (VAS) and Oswestry Disability Index (ODI).
Participants, outcome assessors, and statisticians were blinded, but acupuncturists were not.
TAKEAWAY:
Acupuncture reduced leg pain by 30.8 mm on VAS compared with 14.9 mm in the sham group at week 4 (P < .001).
Disability scores on ODI decreased by 13.0 points in the acupuncture group compared to 4.9 points in the sham group at week 4 (P < .001).
The between-group differences in pain and disability were apparent from week 2 and persisted through week 52.
No serious adverse events were reported, with mild and self-limiting adverse events occurring more frequently in the acupuncture group.
IN PRACTICE:
“Given the large effect sizes that this trial found, acupuncture should be considered to be a potential treatment option for patients with chronic sciatica from herniated disk. Future trials comparing acupuncture with NSAIDs and surgery are needed to evaluate the potential of acupuncture as a first-line treatment for patients with chronic sciatica from herniated disk,” wrote the authors of the study. An accompanying editorial noted that “recent rigorous studies have moved the needle toward accepting acupuncture as an evidence-based treatment for sciatica…. Acupuncture adds an effective, evidence-based, nonpharmacological treatment to address a common chronic condition.”
SOURCE:
The study was led by Jian-Feng Tu, MD, PhD, Beijing University of Chinese Medicine in Beijing, China. It was published online on October 14, in JAMA Internal Medicine. The authors of the editorial are Jerard Z. Kneifati-Hayek, MD, MS, at Columbia University Irving Medical Center, New York, also an editorial intern at JAMA Internal Medicine, and Mitchell H. Katz, MD, at NYC Health + Hospitals, New York, and deputy editor, JAMA Internal Medicine.
LIMITATIONS:
The trial’s limitations include the inability to blind acupuncturists due to the nature of the intervention. Additionally, the study’s findings may not be generalizable to populations outside of China. The reliance on self-reported data for primary outcomes may introduce bias.
DISCLOSURES:
Cun-Zhi Liu, MD, PhD, disclosed receiving grants from the National Key Research and Development Program of China and the National Science Fund for Distinguished Young Scholars. Additional disclosures are noted in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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