Trigger Point Electroacupuncture Treatment in Patients With Chronic Low Back Pain

Evaluation of the Analgesic Efficacy of Trigger Point Electroacupuncture in Patients With Chronic Low Back Pain: a Blinded Randomised Controlled Trial

Electroacupuncture is an application of acupuncture combined with electrical stimulation of acupuncture points through acupuncture needles to achieve faster pain relief than acupuncture. Recently, research has shown that Trigger point acupuncture has a significant effect in reducing pain better than acupuncture on acupoints in patients with chronic low back pain. However, no research has compared the pain relief effect between Trigger Point electroacupuncture and electroacupuncture on acupoints in patients with chronic low back pain. This study was conducted to address this question.

Study Overview

• Status: Completed
• Conditions: Trigger Points; Chronic Low Back Pain (CLBP)
• Intervention / Treatment: Device: Electro-acupuncture

Detailed Description

Participants and Methods: A blinded randomized controlled clinical trial was conducted involving 60 chronic low back pain participants, randomly divided into two groups (A and B): 30 receiving electroacupuncture at the Trigger point (group A) and 30 receiving electroacupuncture on the meridian (group B) for 10 sessions. The primary outcomes were visual analogue scale (VAS), BPI index, and Trigger point count.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Vietnam
  • Ho Chi Minh City, Vietnam
    • University of Medical Center HCMC - Branch no.3, Ho Chi Minh

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients aged 20 or older who consented to participate in the study;
• Individuals experiencing LBP persisting for more than 3 months with an average VAS score of 5 cm or over;
• Patients displaying trigger points in back

Exclusion Criteria:

• Major trauma or systemic disease such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Scheuermann disease;
• Systemic symptoms such as weight loss, fever of unknown origin, anorexia, personal history of malignancy, diffuse pain and joint stiffness;
• Symptoms of infection such as fever, meningeal irritation signs, photophobia;
• Symptoms of central motor neuron damage such as Hoffmann sign, Babinski sign, hyperreflexia, spasticity, incontinence, sexual dysfunction;
• Symptoms of serious acute diseases such as myocardial infarction (chest pain, sweating, shortness of breath), arterial dissections (tearing sensation, headache, blurred vision);
• Conditions unsuitable for acupuncture such as inflammation of skin in need of acupuncture, weak or exhausted patients, severe comorbidities;
• Being treated with other methods. Elimination criteria: Patients experiencing adverse events from the intervention leading to their discomfort and withdrawal from the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Sham Comparator: Electro-acupuncture at traditional points; 30 patients with non-radiating low back pain for at least three months and normal neurological examination received treatment electro-cupuncture at traditional points for 10 sessions over 4 weeks, electroacupuncture was administered once per session, three sessions per week, on alternate days, with rest on Saturdays and Sundays. Visual analogue scale (VAS) will be recorded after 1 session, 3 session, 5 session, 7 session and 10 session. BPI index and Trigger point count will be recorded after 1 session, 5 session, 10 session.	Device: Electro-acupuncture; Electroacupuncture at Trigger Points is electroacupuncture at predetermined trigger points. Electroacupuncture at traditional acupoints is electroacupuncture at the following points: Jiaji (L2-L5), Yaoyangguan (GV3), Shendu (BL23), Dachangdu (BL25), and Weizhong (BL40).
Active Comparator: Electro-acupuncture at the Trigger point; 30 patients with non-radiating low back pain for at least three months and normal neurological examination received treatment electro-acupuncture at the Trigger point for 10 sessions over 4 weeks, electroacupuncture was administered once per session, three sessions per week, on alternate days, with rest on Saturdays and Sundays. Visual analogue scale (VAS) will be recorded after 1 session, 3 session, 5 session, 7 session and 10 session. BPI index and Trigger point count will be recorded after 1 session, 5 session, 10 session.	Device: Electro-acupuncture; Electroacupuncture at Trigger Points is electroacupuncture at predetermined trigger points. Electroacupuncture at traditional acupoints is electroacupuncture at the following points: Jiaji (L2-L5), Yaoyangguan (GV3), Shendu (BL23), Dachangdu (BL25), and Weizhong (BL40).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of VAS pain intensity between electroacupuncture at the trigger point and electroacupuncture traditional point group	With the VAS, participants were asked to make a hatch mark on a 100 mm line that represents their average pain intensity. These were then converted to a numerical score for each face (i.e. 0, 2, 4, 6, 8, or 10), depending on the face selected. The end-point descriptors for VAS was "No pain" (0, 0 mm, and the face representing no pain, respectively) and "The most intense pain imaginable" (10, 100 mm, and the face representing the most intense pain level, respectively).	Baseline, after 3 sessions, after 5 sessions, after 7 sessions, after 10 sessions

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of BPI index between electroacupuncture at the trigger point and electroacupuncture traditional point group.	The BPI gives two main scores: a pain severity score and a pain interference score. The pain severity score is calculated from the four items about pain intensity. Each item is rated from 0, no pain, to 10, pain as bad as you can imagine, and contributes with the same weight to the final score, ranging from 0 to 40. The pain interference score corresponds to the item on pain interference. The seven sub-items (general activity, mood, walking ability, normal walk, relations with other people, sleep, and enjoyment of life) are rated from 0, does not interfere, to 10, completely interferes, and contributes with the same weight to the final score, ranging from 0 to 70. The first item, pain drawing diagrams (painful and most painful areas) and the items on pain relief treatment or medication (list of the treatments and amount of relief) do not contribute to the scoring. It takes approximately 5 minutes to complete the BPI.	Baseline, after 5 sessions, and after 10 sessions

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of trigger point count between electroacupuncture at the trigger point and electroacupuncture traditional point group	Determine the number of trigger points at each survey time.	Baseline, after 5 sessions, and after 10 sessions

Collaborators and Investigators

• Sponsor: University of Medicine and Pharmacy at Ho Chi Minh City

Publications and helpful links

General Publications

• Itoh K, Katsumi Y, Hirota S, Kitakoji H. Effects of trigger point acupuncture on chronic low back pain in elderly patients--a sham-controlled randomised trial. Acupunct Med. 2006 Mar;24(1):5-12. doi: 10.1136/aim.24.1.5.
• Schliessbach J, van der Klift E, Arendt-Nielsen L, Curatolo M, Streitberger K. The effect of brief electrical and manual acupuncture stimulation on mechanical experimental pain. Pain Med. 2011 Feb;12(2):268-75. doi: 10.1111/j.1526-4637.2010.01051.x. Epub 2011 Jan 28.
• Leite PMS, Mendonca ARC, Maciel LYS, Poderoso-Neto ML, Araujo CCA, Gois HCJ, Souza JHS, DeSantana JM. Does Electroacupuncture Treatment Reduce Pain and Change Quantitative Sensory Testing Responses in Patients with Chronic Nonspecific Low Back Pain? A Randomized Controlled Clinical Trial. Evid Based Complement Alternat Med. 2018 Oct 8;2018:8586746. doi: 10.1155/2018/8586746. eCollection 2018.
• Itoh K, Katsumi Y, Kitakoji H. Trigger point acupuncture treatment of chronic low back pain in elderly patients--a blinded RCT. Acupunct Med. 2004 Dec;22(4):170-7. doi: 10.1136/aim.22.4.170.

Study record dates

Study Major Dates

• Study Start (Actual): March 15, 2025
• Primary Completion (Actual): June 30, 2025
• Study Completion (Actual): July 15, 2025

Study Registration Dates

• First Submitted: March 2, 2025
• First Submitted That Met QC Criteria: March 5, 2025
• First Posted (Actual): March 10, 2025

Study Record Updates

• Last Update Posted (Estimated): August 29, 2025
• Last Update Submitted That Met QC Criteria: August 22, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Low back pain; Trigger points; Electro-acupuncture
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain
• Other Study ID Numbers: 2588/DHYD-HDDD

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No