Table 1 Study valign="top" characteristics and critical appraisal of studies examining the effectiveness of acupuncture for low back pain

Haake et al. (2007) [17]

Acupuncture and Sham Acupuncture (x10-12, 30 minute sessions) and Guideline Based Conventional Therapy

1162

18- 86 years

> 6 months of non specific Low Back Pain

Von korff Chronic Pain Scale

6/52

Significant difference between acupuncture over conventional therapy. No significant difference between acupuncture and sham.

Mean age 50 years

3/12

HFAQ

6/12

SF-12

1-6 scale of how good Treatment was

Medication use

Witt et al. (2006) [16]

Manual acupuncture and no acupuncture control group and non randomized cohort.

11378

> 18 years

> 6 months of non specific Low Back Pain

HFAQ

3/12

Significant improvement in acupuncture group in back pain and function and cost effectiveness

Mean age 52.9 years

SF-36

6/12

Low Back Pain Rating Scale

Maximum of 15 sessions

Cost effectiveness

Brinkhaus et al. (2006) [18]

Manual acupuncture and Sham acupuncture using superficial acupoints (x12, 30 minute sessions over 8 weeks)

298

40-75 years

> 6 months of non specific Low Back Pain

VAS

8/52

Significant difference between acupuncture and no treatment. No difference between acupuncture and sham

Pain Disability Index

26/52

SF-36

1 year

Emotional aspects of pain, depression, time with limited function/ pain/ analgesics taken

No Treatment.

Thomas et al. (2006) [19]

Traditional manual acupuncture (10 sessions) Usual Care

241

18- 65 years

4-52 weeks of non specific Low Back Pain

SF-36

3/12

Significant difference at 24 months of small difference in the acupuncture group in the pain dimension of the SF-36.

EuroQol

1 year

Oswestry Disability Index

2 years

McGill Pain Index

Analgesics

Cherkin et al (2009) [20]

Individualised acupuncture (5-20 needles for 15-20 minutes), Standardized acupuncture (8 acupuncture points for 20 minutes), Simulated acupuncture (toothpick and needle guide), (All 10 sessions) Usual care

638

18-70 years

> 3 months non specific low back pain

Roland Morris Disability Questionnaire (RMDQ)

8/52

Significant difference between all acupuncture including individualized, standardized and simulated acupuncture and usual care in RMDQ at 8/52 and 26/52. No difference between acupuncture and sham.

26/52

Bothersome Score

1 year

Physical and Mental health component of SF-36

Analgesics

Days spent in bed/ loss of work days

No difference at 1 year.

Kerr et al (2003) [21]

Standardized acupuncture (11 needles for 30 minutes, 10 sessions)

46

> 18 years

> 6 months

SF-36

6/52

Significant improvement in all outcomes for acupuncture. Significant improvement in SF-36, ROM and VAS for placebo TENS.

Mean age 41.2 years

Lumber flexion ROM

6/12

Placebo TENS (4 electrodes, switched off, 30 minutes, 10 sessions)

Pain Rating Index (PRI) of the McGill Pain Questionnaire (MPQ)

No significant difference between the 2 groups.

VAS

Leibing et al (2002) [14]

Physiotherapy (26 sessions), Physiotherapy (26 sessions) and traditional and standardized acupuncture (20 sessions, needle insertion 10-30mm), Physiotherapy (26 sessions) and sham acupuncture (20 sessions, needle insertion 10-20mm)

131

18-65 years

> 6 months

Pain intensity (VAS)

12/52

Significant improvement in acupuncture group in all outcomes over control at 12/52. pain intensity (p<0.01), pain disability (p<0.01), Psychological distress (p<0.05). No significant difference in sham acupuncture and acupuncture.

Pain Disability Index Hospital Anxiety and Depression Scale Lumbar spine flexion

1 year