Across the globe, industrialized nations suffer from low back pain. In the United States alone, the yearly healthcare costs associated with this condition reaches over $100 billion per year. Up to another.
Methods for Searching and Selecting Data
The findings were discovered with a variety of medical databases using their records stretching back from their inception up to lumbago.
The team of Lizhou Liu, Leon Marie, and Jondong Wang worked independently from one another, cross-referencing full-papers, while working through disagreements in methodology to provide a robust assessment of different studies. However, the preferred points of data were random controlled tests as those would provide the most reliable results when determining whether or not acupuncture served as an effective method on non-invasive treatment for both long and short-term back pain.
Efficacy was measured based on the effect on pain relief, overall improvement, functional improvement, and effectiveness rate which compares the degree of improvement within a similar group—in this instance, those suffering from the condition. The specific style of treatment was not monito include all acupuncture for lower back pain procedures.
Extracting and Assessing the Quality of Data
The team was primarily interested in defining the acupuncture style and whether the treatment worked as well as a methodological quality of the studies. They also included the examination of the descriptive characteristics, the approaches of data analysis, and the conclusions or main findings. This method was utilized for both English and non-English sources. To make the meta-analysis more accurate, studies were given a rating between low and high. These ratings were based on the specific data point’s use of the Jedad Scale and the PEDro scale.
Moreover, the data was weighted by low drop-out rates and high follow-up rates, then cross-referenced with other group tests to assign a score that determined the degree of agreement in quality. A score below 4 is low quality while a score 8 or above was high quality. Everything in between is considered moderate and the grades determined the strength of evidence.
Data Synthesis and Clinical Relevance
The studies reviewed were tor separated by pain relief and functional improvement or overall improvement and effectiveness rate. Finally, the time between follow-ups ranged from less than 3 months for short-term and more than 1 year for long-term.
To ensure that the studies included in the meta-analysis are the most valuable, the team removed the low-quality studies which allowed application of the results for clinical fields to be more relevant. This also helped group the magnitudes for the different control groups and focus specifically on patients of received acupuncture treatment for the condition.
Results – Review Selection and Characteristics and Acupuncture Details
With over 1000 records accumulated from almost 800 different publications including 70 papers met the standards for review. However, most of the papers were not acceptable leaving only 20 acceptable full-text articles for inclusion. After excluding four reviews from a single journal and three others from journal articles, only 75 percent of the remaining reviews were included in the final analysis. A meta-analysis composed of thirteen different systematic reviews produced a best-evidence synthesis and two studies for both qualitative and quantitative analyses. However, one of the independent reviewers focused exclusively on qualitative analyses. The sources were English-speaking, Chinese, and Japanese in origin—though primarily in English. Unfortunately, the studies were inconsistent in regards to the quality of random controlled tests. The studies covered long-term, short-term, and a mixture of both long and short-term trials. However, the Chinese studies focused exclusively on disc herniation in for both specific and nonspecific back pain.
Results – Data Point Conclusions
Only short-term follow-up studies, those of 3 months or less, could be assessed due to a lack of consistent follow-up definition within the systematic reviews. Those reviews were then split further between 6-week follow-up intervals and 3-month follow-up intervals. However, only those studies which exclusively included acupuncture for low back pain as the other heterogeneous results could confound the meta-analysis. In the end, only four pain relief and functional improvement with short follow-up control groups qualified.
Results – Short and Long-Term Lower Back Pain
For short-term pain reviews, the meta-analysis judged false and legitimate acupuncture techniques. For pain relief, the reviews did not give consistent results. Some of the reviews identified no difference between legitimate and false techniques. However, other reviews found a statistically relevant correlation. For functional improvement, again no difference between false and legitimate techniques was found either for short-term low back pain.
The studies on long-term back pain also examined the difference in result between false and legitimate techniques, though the definition for false techniques varied from review to functional improvement. Moreover, while there was no clear consensus on the definition of what no treatment, legitimate techniques showed better results than no treatment at all, and legitimate techniques when used in conjunction with conventional treatment proved more effective than conventional treatment alone.
Discussion – Statement of Findings
When studying systematic reviews to suggest that false techniques provided any benefit over legitimate techniques. Moreover, legitimate techniques demonstrated better results for pain relief and functional limitations over no treatment.
Discussion – Internal and External Veracity of the Studies Examined
Since so few of the reviews met the acceptable quality standard, the meta-analysis identified some common areas of improvement. To start, more weight should be given to be included in conjunction with assessment of multiple systematic reviews may account for these issues.
The use of treating with false techniques as a control may be questionable. In this instance, false techniques involve the use of unsharpened needles. Moreover, these techniques may also involve a misalignment with the specific pressure points the legitimate techniques demand. However, this latter divergence may actually be an adequate control as the principle of using legitimate technique for the condition relies on the precise application of the technique along the meridian system.
Still, that to integrate care holistically, the evidence suggests it does not. Also, most patients who suffer from the condition are treated using self-reported analyses which in and of itself offers all forms of treatment the possibility of being psychologically influenced.
Discussion – Meta-Study Strengths
Every measure of this meta-analysis sought to increase applicability.
Discussion – Uses for Practice and Research
No conclusive efficacy regarding the use of legitimate techniques of acupuncture for low back pain in the short-term could be found. However, the sample size included only two acceptable studies. But in regards to false techniques.
Conclusion
Half a dozen reviews indicate legitimate techniques to false techniques for short-term lower back pain—and it is recommended that more high-quality studies of legitimate techniques are conducted. Regardless, the possibility of using the treatment of acupuncture for low back pain offers promise and is far from being discredited.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating the full thickness tear and already occurring muscle atrophy due to misdiagnosis and not referring the patient to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed to be a complete tear with muscle contraction under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris with large hematoma (blood)
Separation of muscle ends due to tear elicited on dynamic sonography examination
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