Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis

Zongshi Qin, Xiaoxu Liu, Jiani Wu, Yanbing Zhai, Zhishun Liu, Zongshi Qin, Xiaoxu Liu, Jiani Wu, Yanbing Zhai, Zhishun Liu

Abstract

This is a systematic review and meta-analysis, which aimed to assess the current evidence on the effects and safety of acupuncture for treating sciatica. In this review, a total of 11 randomized controlled trials were included. As a result, we found that the use of acupuncture may be more effective than drugs and may enhance the effect of drugs for patients with sciatica, but because of the insufficient number of relevant and rigorous studies, the evidence is limited. Future trials using rigorous methodology, appropriate comparisons, and clinically relevant outcomes should be conducted.

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Study flow diagram.
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References

    1. Tarulli A. W., Raynor E. M. Lumbosacral radiculopathy. Neurologic Clinics. 2007;25(2):387–405. doi: 10.1016/j.ncl.2007.01.008.
    1. Waddell G. The Back Pain Revolution. Edinburgh, UK: Churchill Livingstone; 1998.
    1. Mathieson S., Maher C. G., McLachlan A. J., et al. PRECISE—pregabalin in addition to usual care for sciatica: study protocol for a randomised controlled trial. Trials. 2013;14, article 213 doi: 10.1186/1745-6215-14-213.
    1. Frymoyer J. W. Lumbar disk disease: epidemiology. Instructional Course Lectures. 1992;41:217–223.
    1. Frymoyer J. W. Back pain and sciatica. The New England Journal of Medicine. 1988;318(5):291–300. doi: 10.1056/nejm198802043180506.
    1. Konstantinou K., Dunn K. M. Sciatica: review of epidemiological studies and prevalence estimates. Spine. 2008;33(22):2464–2472. doi: 10.1097/brs.0b013e318183a4a2.
    1. Lewis R. A., Williams N. H., Sutton A. J., et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. The Spine Journal. 2015;15(6):1461–1477. doi: 10.1016/j.spinee.2013.08.049.
    1. Carette S., Leclaire R., Marcoux S., et al. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus. The New England Journal of Medicine. 1997;336(23):1634–1640. doi: 10.1056/nejm199706053362303.
    1. Finckh A., Zufferey P., Schurch M.-A., Balagué F., Waldburger M., So A. K. L. Short-term efficacy of intravenous pulse glucocorticoids in acute discogenic sciatica. A randomized controlled trial. Spine. 2006;31(4):377–381. doi: 10.1097/01.brs.0000199917.04145.80.
    1. Korhonen T., Karppinen J., Paimela L., et al. The treatment of disc herniation-induced sciatica with infliximab: results of a randomized, controlled, 3-month follow-up study. Spine. 2005;30(24):2724–2728. doi: 10.1097/01.brs.0000190815.13764.64.
    1. Van Tulder M. W., Koes B., Seitsalo S., Malmivaara A. Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review. European Spine Journal. 2006;15(1):S82–S92. doi: 10.1007/s00586-005-1049-5.
    1. Luijsterburg P. A. J., Verhagen A. P., Ostelo R. W. J. G., Van Os T. A. G., Peul W. C., Koes B. W. Effectiveness of conservative treatments for the lumbosacral radicular syndrome: a systematic review. European Spine Journal. 2007;16(7):881–899. doi: 10.1007/s00586-007-0367-1.
    1. Zhao Z.-Q. Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology. 2008;85(4):355–375. doi: 10.1016/j.pneurobio.2008.05.004.
    1. Kavoussi B., Ross B. E. The neuroimmune basis of anti-inflammatory acupuncture. Integrative Cancer Therapies. 2007;6(3):251–257. doi: 10.1177/1534735407305892.
    1. Zijlstra F. J., van den Berg-De Lange I., Huygen F. J. P. M., Klein J. Anti-inflammatory actions of acupuncture. Mediators of Inflammation. 2003;12(2):59–69. doi: 10.1080/0962935031000114943.
    1. Inoue M., Kitakoji H., Yano T., Ishizaki N., Itoi M., Katsumi Y. Acupuncture treatment for low back pain and lower limb symptoms—the relation between acupuncture or electroacupuncture stimulation and sciatic nerve blood flow. Evidence-Based Complementary and Alternative Medicine. 2008;5(2):133–143. doi: 10.1093/ecam/nem050.
    1. Wang Z.-X. Clinical observation on electro-acupuncture at acupoints for treatment of senile radical sciatica. Zhongguo Zhen Jiu. 2009;29(2):126–128.
    1. Qin Z., Liu X., Yao Q., Zhai Y., Liu Z. Acupuncture for treating sciatica: a systematic review protocol. BMJ Open. 2015;5(4) doi: 10.1136/bmjopen-2014-007498.
    1. Liberati A., Altman D. G., Tetzlaff J., et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. The BMJ. 2009;339, article b2700 doi: 10.1136/bmj.b2700.
    1. Wang B.-X., La L. J. Therapeutic effects of electro-acupuncture and diclofenic on herniation of lumbar intervertebral disc. Chinese Journal of Clinical Rehabilitation. 2004;8(17):3413–3415.
    1. Chen M.-R., Wang P., Cheng G., Guo X., Wei G.-W., Cheng X.-H. The warming acupuncture for treatment of sciatica in 30 cases. Journal of Traditional Chinese Medicine. 2009;29(1):50–53. doi: 10.1016/S0254-6272(09)60031-5.
    1. Zeng Y. Y. Slow twist combined with pricking blood therapy by Qi stagnation and Blood stasis type of root sciatica in clinical research. Unpublished data, 2012 (Chinese)
    1. Zhang B.-M., Wu Y.-C., Shao P., Shen J., Jin R.-F. Electro-acupuncture therapy for lumbar intervertebral disc protrusion: a randomized controlled trial. Journal of Clinical Rehabilitative Tissue Engineering Research. 2008;12(2):353–355.
    1. Hu Z. C., Shen L. H., Wu Y. C. Observations on the therapeutic effect of electro-acupuncture on lumbar intervertebral disc herniation. Shanghai Journal of Acupuncture and Moxibustion. 2010;29(11):722–724.
    1. Du Z., Shao P., He Y. H., et al. Clinical observation on 32 cases of lumber intervertebral disc herniation treated by electro-acupuncture on Huatuo Jiaji points. Journal of Traditional Chinese Medicine. 2009;50(7):617–619.
    1. Chen W. K. Clinical study of acupuncture in sciatica patients. 2010 (Chinese)
    1. Wang X. G. Clinical study of acupuncture for treating 52 cases of lumber intervertebral disc herniation. Asia-Pacific Traditional Medicine. 2008;4(9):39–40.
    1. Meng R. Efficacy of electro-acupuncture therapy and medication treatment on lumbar disc herniation. Journal of Clinical Acupuncture and Moxibustion. 2014;30(9):30–32.
    1. Ren Y. X. Clinical observation on 30 cases of lumber intervertebral disc herniation treated by warm needling combined with medicine. Jiangsu Journal of Traditional Chinese Medicine. 2013;45(9):62–63.
    1. Zhao H. L. Clinical study of electro-acupuncture on Huangtiao point to treat sciatica. Unpublished data, 2004 (Chinese)
    1. Higgins J. P., Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration; 2011.
    1. Higgins J. P. T., Altman D. G., Gøtzsche P. C., et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal. 2011;343(7829) doi: 10.1136/bmj.d5928.d5928
    1. Zeng M. G. Clinical comparative analysis of acupuncture and medicine in treating patients with lumbosacral radicular pain. China Health Industry. 2012;18:p. 174.
    1. Sterne J., Egger M., Moher D. Addressing reporting biases. In: Higgins J., Green S., editors. Cochrane Handbook for Systematic Reviews of Intervention. Chichester, UK: The Cochrane Collaboration, John Wiley & Sons; 2008. pp. 297–333.
    1. MacPherson H., Altman D. G., Hammerschlag R., et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): extending the CONSORT statement. PLoS Medicine. 2010;7(6) doi: 10.1371/journal.pmed.1000261.e1000261
    1. Duplan B., Cabanel G., Piton J. L., Grauer J. L., Phelip X. Acupuncture and sciatica in the acute phase. Double-blind study of 30 cases. Semaine des Hopitaux. 1983;59(45):3109–3114.
    1. Samanta A., Beardsley J. Evidence based case report: sciatica: which intervention? The British Medical Journal. 1999;319:302–303.
    1. Vroomen P. C. A. J., de Krom M. C. T. F. M., Slofstra P. D., Knottnerus J. A. Conservative treatment of sciatica: a systematic review. Journal of Spinal Disorders. 2000;13(6):463–469. doi: 10.1097/00002517-200012000-00001.
    1. Koes B. W., van Tulder M. W., Peul W. C. Diagnosis and treatment of sciatica. British Medical Journal. 2007;334(7607):1313–1317. doi: 10.1136/.
    1. Schulz K. F., Altman D. G., Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine. 2010;152(11):726–732. doi: 10.7326/0003-4819-152-11-201006010-00232.
    1. Lee H., Lee J.-H., Choi T.-Y., Lee M. S., Lee H., Shin B.-C. Acupuncture for acute low back pain: a systematic review. Clinical Journal of Pain. 2013;29(2):172–185. doi: 10.1097/ajp.0b013e31824909f9.

Source: PubMed

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