Suture Embedding Acupuncture for Chronic Low Back Pain: A Randomized, Sham-Controlled Clinical Trial

Suture embedding acupuncture is one of the most often used interventions for the treatments of chronic low back pain (cLBP). The investigators will investigate the efficacy and safety of suture embedding acupuncture for cLBP in this single center, parallel, randomized, sham-controlled clinical trial.

Participants will be randomized into 2 groups (real acupuncture and sham acupuncture) by central allocation. Randomized participants will complete a questionnaire that solicited information regarding age, sex, marital status, occupation, education, and medical history. The blinding credibility of the treatments will be evaluated at the end of the treatment.

Real Suture embedding Acupuncture for Treatment Group To make the real suture embedding acupuncture treatment reflect an ordinary clinical practice condition, participants received standardized acupuncture treatment. That treatment was accomplished by selecting a group of acupuncture points that predefined. Acupuncture points will be bladder meridian pattern acupuncture points including Shenshu (BL23), Qihaishu (BL24), Dachangshu (BL25), and Yimmen (BL37). Treatment will be given using sterile, disposable stainless steel 23G or 25G injection needles with 1 mm 5.0 Vicryl suture inside the needle. The needles will be inserted perpendicular to a depth of 5 to 35 mm depending on the acupuncture point, which was followed by manual stimulation by bidirectional rotation to induce Deqi sensation. Deqi was defined as a dull, localized, and aching sensation, which signaled the attainment of qi. After the Deqi sensation being achieved, the suture will be embedded with a sterile stainless steel needle. After needle removal, a 5mm × 5 mm sterile tape will be adhered to the needle hole. Patients will be asked not to remove the tape unless necessary.

Sham Acupuncture for Control Group Treatment will be given using sterile, disposable stainless steel 30G or 32G acupuncture needles. The acupuncture points will be the same as real suture embedding acupuncture group. The needles will be inserted perpendicular to a depth of 5 to 35 mm depending on the acupuncture point and will be pulled up immediately. After sham acupuncture, the point will be adhered a sterile tape as real group. Patients will be asked not to remove the tape unless necessary.

Outcome Measures Primary Outcome Measure The primary outcome measure is VAS for LBP. To understand the impact of cLBP on the participants' life, VAS for bothersomeness is chosen instead of pain intensity. The participants will be asked to mark, on a 10 cm VAS (0, absence of bothersomeness; 10, the worst bothersomeness imaginable), the average degree of bothersomeness due to LBP experienced within the most recent 1 week from the day of the assessment. This measurement has substantial validity. Bothersomeness of LBP will be measured at baseline, 2-, 4-, 8-, 12-, 16-, 20-, and 24-week. The primary endpoint is the 8-week follow-up (i.e., 4 wk after finishing all of the treatments).