Battlefield Acupuncture Versus Standard Pharmacologic Treatment of Low Back Pain in the Emergency Department: A Randomized Controlled Trial

Background: Battlefield acupuncture (BFA) offers a novel analgesic option that avoids the need for pharmacologic interventions with problematic side effect profiles. Objective: To compare BFA with standard pharmacologic interventions to treat patients in the emergency department (ED) with low back pain. Methods: We conducted a non-blinded randomized controlled trial of a convenience sample of adults presenting to an urban tertiary care ED with a chief complaint of low back pain. We randomized subjects to undergo either BFA or the control arm in which they received standard pharmacologic therapies at the discretion of their treating clinician. The primary outcome was mean pain reduction measured on a 100-mm visual analogue scale (VAS) from enrollment to 30-40 min postintervention. Secondary outcomes included the Back Pain Functional Scale (BPFS; scores range from 0-60) measured at 30-40 min postintervention and again at 48-72 h postintervention. Results: We enrolled 52 subjects with 26 randomized to each arm. The mean decrease in pain VAS was 33.4 mm among patients undergoing BFA vs. 21.5 mm in the control arm (effect size difference 12.0 mm [95% confidence interval {CI} 0.1-23.8 mm]). The median improvement in the BPFS score at 48-72 h postintervention was 12.0 among patients undergoing BFA vs. 8.0 in the control arm (effect size difference 4 [95% CI -9.0 to 16.0]). There were no adverse events. Conclusions: BFA shows promise for further study as an alternative to standard pharmacologic interventions among adults presenting to the ED with low back pain. (C) 2021 Elsevier Inc. Published by Elsevier Inc.