Pain Project: evaluating the effectiveness of acupuncture in the treatment of low back pain.
Back pain is a major cause of ill health and time lost from work. The ‘orthodox’ treatments often have limited success and the NHS has identified back pain as a priority condition for research. A literature review revealed that acupuncture can be an effective treatment though there is a lack of high quality research trials. The Foundation therefore identified low back pain as a priority research area.
In preparation for a randomised controlled trial, a feasibility study was carried out in which GPs referred four patients with chronic low back pain to an acupuncture clinic in York for a course of ten treatments (Fitter & MacPherson, 1995). The purpose was to test out our methods of assessing the outcomes of treatment. These results were encouraging in terms of procedures, end-point measures and outcomes. A full pilot study was undertaken with twenty patients being referred to two acupuncture clinics in York by local GPs and also by consultants in the Pain Clinic at the NHS hospital in York (MacPherson et al 1999).
In collaboration with Kate Thomas of the Medical Care Research Unit at Sheffield University, this project was developed into a successful application for funding from the Department of Health R & D Health Technology Assessment Programme. The research design is that of a pragmatic randomised controlled trial to evaluate the evidence for the clinical benefits, the cost effectiveness and the safety of acupuncture for chronic low back pain (Thomas et al 1999).
The trial involves 240 patients referred by 35 GPs from the York Primary Care Group and then randomised to the offer of acupuncture or to normal GP management. The acupuncture group will receive up to 10 treatments from 6 acupuncturists based at two centres in York. In-depth interviews with selected patients are helping us capture the patients’ strategies for coping with low back pain and their experience of acupuncture.
The trial started in the summer of 1999 and there will be two years of data collecting before the results of this study can be analysed and published.