PainSci summary of Hsieh 2006?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
In 2004, this research team produced promising evidence that back pain may be effectively treated with acupressure — like acupuncture, but without the needles. Two years later, in this study, they reproduced this evidence for British Medical Journal, a much more prominent journal. According to the BMJ’s superb commentary (see Frost):
It was well conducted in terms of randomisation, blinding, loss to follow-up, and analysis. The differences between the groups in standard outcome measures of disability, pain scores, and functional status are striking. The difference immediately after treatment and at six months was more than twice that reported in trials of conventional back pain interventions and of acupuncture. If these results are valid, acupressure would seem to represent an efficacious treatment for low back pain and we might need to ask why Chinese medicine clinicians use acupuncture for back pain, rather than acupressure.
But there are complex caveats, and Frost does an excellent job of explaining them. There are several good reasons to keep optimism cautious in this case. There’s no denying it’s interesting and promising, but the results definitely need to be replicated in a different cultural context.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: To evaluate the effectiveness of acupressure in terms of disability, pain scores, and functional status.
DESIGN: Randomised controlled trial.
SETTING: Orthopaedic clinic in Kaohsiung, Taiwan.
PARTICIPANTS: 129 patients with chronic low back pain.
INTERVENTION: Acupressure or physical therapy for one month.
MAIN OUTCOME MEASURES: Self administered Chinese versions of standard outcome measures for low back pain (primary outcome: Roland and Morris disability questionnaire) at baseline, after treatment, and at six month follow-up.
RESULTS: The mean total Roland and Morris disability questionnaire score after treatment was significantly lower in the acupressure group than in the physical therapy group regardless of the difference in absolute score (- 3.8, 95% confidence interval - 5.7 to - 1.9) or mean change from the baseline (- 4.64, - 6.39 to - 2.89). Acupressure conferred an 89% (95% confidence interval 61% to 97%) reduction in significant disability compared with physical therapy. The improvement in disability score in the acupressure group compared with the physical group remained at six month follow-up. Statistically significant differences also occurred between the two groups for all six domains of the core outcome, pain visual scale, and modified Oswestry disability questionnaire after treatment and at six month follow-up.
CONCLUSIONS: Acupressure was effective in reducing low back pain in terms of disability, pain scores, and functional status. The benefit was sustained for six months.
- “A randomized controlled clinical trial for low back pain treated by acupressure and physical therapy,” Lisa Li-Chen Hsieh, Chung-Hung Kuo, Ming-Fang Yen, and Tony Hsiu-Hsi Chen, Prev Med, 2004.
Specifically regarding Hsieh 2006:
- “Acupressure for low back pain,” Helen Frost and Sarah Stewart-Brown, British Medical Journal, 2006.
One article on PainScience.com cites Hsieh 2006 as a source:
- PS Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.