Acupuncture for low back pain in older adults with degenerative lumbar spinal stenosis: a secondary analysis of a randomized clinical trial

Background Low back pain contributes to the burden of degenerative lumbar spinal stenosis (DLSS) in older adults. We compared acupuncture with sham acupuncture (SA) for low back pain in this population. Methods This secondary analysis of a randomized trial included 113 adults aged 65–80 years with DLSS, neurogenic claudication, and low back pain. Participants had been randomized to acupuncture (n = 55) or SA (n = 58), with 18 treatment sessions scheduled over 6 weeks. The primary outcome was change from baseline in the numeric rating scale for low back pain (NRS-back) at week 6. Secondary outcomes included numeric rating scale for buttock and/or leg pain (NRS-buttock/leg), modified Roland-Morris Disability Questionnaire (RMDQ), Swiss Spinal Stenosis Questionnaire (SSSQ), and Hospital Anxiety and Depression Scale (HADS). Analyses used mixed models for repeated measures and generalized estimating equations. Results At week 6, the adjusted between-group difference in NRS-back change was −0.9 (95% confidence interval [CI], −1.7 to −0.1). Acupuncture significantly reduced NRS-back at weeks 18 and 30 and NRS-buttock/leg and SSSQ symptom severity scores at week 18 compared with SA. At week 6, acupuncture was associated with a higher proportion of participants achieving ≥30% improvement in NRS-back than SA (between-group difference, 22.9 percentage points; 95% CI, 4.0 to 41.8). No statistically significant between-group differences were observed in mean changes in modified RMDQ, SSSQ physical function, or HADS scores. Conclusion Acupuncture may provide greater relief of low back pain than SA, suggesting its potential as a nonpharmacological option for older adults with DLSS.