Efeito da acupuntura e do laseracupuntura na dor e capacidade funcional de pacientes com dor lombar crônica não específica: ensaio clínico, randomizado, duplo-cego

Abstract

INTRODUCTION: Low back pain can cause great personal suffering, with the possible consequence of disability and reduced quality of life and work productivity, in addition to generating high socioeconomic costs for patients and society. OBJECTIVE: The aim of this study was to compare the effects of acupuncture (ACP) and laser acupuncture (LACP) on pain and functional capacity in patients with chronic nonspecific low back pain (NS-LBP). METHODS: This was a randomized, controlled blinded clinical trial with 44 patients with chronic NS-LBP, aged between 29 and 70 years (mean: 44.68±12.22 years, 63.65% women), randomly allocated to the following treatments: ACP (n=22) and LACP (n=22). Participants received treatment twice a week, for a total of 10 sessions. The primary end point was pain, as measured by the Numerical Rating Scale (NRS [measured by a numerical scale from 0 to 10]). As secondary outcomes were considered: specific disability (Patient-specific functional scale [PSFS]-measured by a numerical scale from 0 to 10), general disability (Oswestry Disability Questionnaire- ODQ), lumbar flexibility (measurement of the distance between the tips of the fingers to the ground) and pain after lumbar flexibility test. Participants were assessed at different times: (1) pre-intervention, (2) post-intervention (one week after completion of the intervention), and (3) one month post-intervention (for the primary outcome). The analysis was by intention to treat using mixed linear models. RESULTS: Both treatments provided a significant reduction in pain assessed by NRS after 1 week and after 1 month of treatment. However, no significant difference was found between the groups for one week after completion of treatment (Mean difference= -0.53; 95%CI -1.57 to 0.50; p=0.31) and post 1 month (Mean difference=0.16; 95%CI -0.87 to 1.20; p=0.75). For the outcomes PEF, OQ, Lumbar flexibility and post lumbar flexibility test pain analyzed after one week of treatment completion, no significant difference was found between the groups. However, in the intra-group analysis, all outcomes indicated significant improvement in relation to the observed pre-treatment conditions for both groups. CONCLUSIONS: In this study, it was possible to verify that acupuncture and laseracupuncture contribute to the reduce of pain and improvement functional capacity in patients with chronic nonspecific low back pain. These results confirm that points BL 23, BL 25, BL 40, BL 62, SI 3 and EX-B2 provided a good clinical response for the treatment of these patients. These acupuncture points, when irradiated with laser acupuncture at a dose of 6 J, provide a result similar to that observed with needling. Clinical Trials register: NCT05310214.