Acupuncture for Chronic Low Back Pain in the Elderly: A Sham-Controlled Randomized Controlled Trial Focusing on Pain Relief and Functional Outcomes

Abstract

Objective

Chronic low back pain (CLBP) is highly prevalent among older adults and is associated with substantial functional impairment and reduced quality of life. This study aimed to evaluate the efficacy and safety of a standardized acupuncture protocol compared with sham acupuncture for pain relief and functional improvement in elderly patients with CLBP.

Methods

This single-center, participant- and outcome assessor-blind, randomized controlled trial was conducted between March 2022 and January 2025. A total of 106 participants aged ≥65 years with nonspecific CLBP were randomly assigned (1:1) to receive either acupuncture or sham acupuncture. Both groups received 16 treatment sessions over 8 weeks. The primary outcome was change in pain intensity measured by the visual analog scale (VAS) at week 8. Secondary outcomes included functional disability assessed by the Oswestry disability index (ODI), health-related quality of life measured by the SF-12, and adverse events. Analyses were performed according to the intention-to-treat principle, with missing data imputed using the last observation carried forward method.

Results

Of the 106 randomized participants, 101 (50 in the acupuncture group, 51 in the sham group) completed the 8-week trial and 12-week follow-up. At week 8, the acupuncture group showed a significantly greater reduction in VAS pain scores compared with the sham group (−3.2 ± 1.1 cm vs −1.7 ± 1.3 cm), with an adjusted between-group difference of −1.5 cm [95% confidence interval (CI): −2.0 to −1.0; P < 0.001]. Functional disability improved significantly in the acupuncture group, with a greater reduction in ODI scores than in the sham group (between-group difference: −10.2%, 95% CI: −14.5 to −5.9; P < 0.001). Improvements in the SF-12 physical component score favored acupuncture, while no significant difference was observed in the mental component score. No serious adverse events were reported.

Conclusion

An 8-week course of standardized acupuncture was more effective than sham acupuncture in reducing pain and improving physical function in elderly patients with CLBP, with a favorable safety profile. These findings support acupuncture as a viable non-pharmacological option for short-term (up to 12 weeks) management of CLBP in the elderly.