Original Investigation
October 14, 2024
Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial
Jian-Feng Tu, Guang-Xia Shi, Shi-Yan Yan, et al
JAMA Intern Med. 2024;184(12):1417-1424. doi:10.1001/jamainternmed.2024.5463
Question Does acupuncture alleviate pain and improve function in patients with chronic sciatica from herniated disk?
Findings This multicenter randomized clinical trial found a statistically significant difference in the mean decrease in leg pain using the visual analog scale, from baseline to week 4 (30.8 mm with acupuncture vs 14.9 mm with sham acupuncture). The findings for function using the Oswestry Disability Index were similar (13.0 vs 4.9 points).
Meaning Acupuncture alleviates pain and improves function among patients with chronic sciatica from herniated disk and should be considered as a potential treatment option.
Abstract
Importance Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce.
Objective To investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk.
Design, Settings, and Participants This was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk. Participants were recruited from March 25, 2021, to September 23, 2021, with a final follow-up through September 22, 2022. Data analyses were performed from December 2022 to March 2023.
Interventions Participants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded.
Main Outcomes and Measures The 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4. Secondary outcomes were adverse events.
Results A total of 216 patients (mean [SD] age, 51.3 [15.2] years; 147 females [68.1%] and 69 males [31.9%]) were included in the analyses. The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4 (mean difference, −16.0; 95% CI, −21.3 to −10.6; P < .001). The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4 (mean difference, −8.1; 95% CI, −11.1 to −5.1; P < .001). For both VAS and ODI, the between-group difference became apparent starting in week 2 (mean difference, −7.8; 95% CI, −13.0 to −2.5; P = .004 and −5.3; 95% CI, −8.4 to −2.3; P = .001, respectively) and persisted through week 52 (mean difference, −10.8; [95% CI, −16.3 to −5.2; P < .001; and −4.8; 95% CI, −7.8 to −1.7; P = .003, respectively). No serious adverse events occurred.
Conclusions and Relevance This randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52. Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk.
Trial Registration Chictr.org Identifier: ChiCTR2100044585
