Efficacy and Safety of Warm Acupuncture Compared to Gabapentin for Pain Management in Patients with Sciatica in Bhutan: A Randomized Controlled (ACUWARM) Trial

Introduction Sciatica is a significant health issue, primarily affecting the young population, and causes considerable distress. Acupuncture has been investigated as a potential treatment to address the gap in effective management options for sciatica. This study aimed to compare pain severity, disability, and quality of life, and adverse events in subjects with sciatica receiving warm acupuncture compared those receiving oral gabapentin. Methods This randomized controlled non-inferiority clinical trial involved the use of the minimization technique for randomization. Seventy participants were enrolled and divided into two groups: Warm Acupuncture Group and Gabapentin Group. Results On Day 15, the Visual Analogue Scale (VAS) score was significantly lower in the acupuncture group compared to the gabapentin group (4.3 vs 5.2, P = .029). On Day 30, the VAS score further decreased in the acupuncture group (1.4 vs 3.6, P < .001). Warm acupuncture demonstrated non-inferiority in reducing low back pain at Day 30 and showed significant improvement in gluteal, thigh, and leg pain scores on Days 15 and 30. Improvements in disability scores were significantly higher in the acupuncture group on Days 15 (73.7% vs 22.3%) and Day 30 (92.3% vs 44.6%). No adverse events related to warm acupuncture were reported. Conclusion The standardized protocol of warm acupuncture was non-inferior to gabapentin in reducing pain severity by Days 15 and 30. Warm acupuncture resulted in higher improvements in disability scores with no reported adverse events. Thus, warm acupuncture presents a viable alternative to gabapentin for managing pain in patients with sciatica.