Autonomic status and pain profile in patients of chronic low back pain and following electro acupuncture therapy: A randomized control trial.
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Date
2011-01
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Abstract
Pain is a syndrome characterized by several neurophysiological
changes including that of the autonomic nervous system. Chronic low back
pain (LBP) is a major health problem and is a frequent reason for using
unconventional therapies especially acupuncture. This study was conducted
to evaluate the autonomic status and pain profile in chronic LBP patients
and to observe the effect of electro acupuncture therapy. Chronic LBP
patients (n=60) were recruited from the Department of Orthopaedics, GTB
Hospital, Delhi. Age and sex matched healthy volunteers were selected as
controls (n=30). Following a written consent, LBP patients were randomly
allocated into two study groups – Group A received 10 sittings of electro
acupuncture, on alternate days, at GB and UB points selected for back
pain, while the Group B received a conventional drug therapy in the form
of oral Valdecoxib together with supervised physiotherapy. Controls were
assessed once while the patients were assessed twice, before and after
completion of the treatment program (3 weeks). The autonomic status was
studied with non-invasive cardiovascular autonomic function tests which
included E: I ratio, 30:15 ratio, postural challenge test and sustained handgrip
test. Pain intensity was measured with the visual analogue scale (VAS) and
the global perceived effect (GPE). Statistical analysis was performed using
repeated measure’s ANOVA with Tukey’s test. Pain patients showed a
significantly reduced vagal tone and increased sympathetic activity as
compared to the controls (P<0.05 to P<0.001 in different variables). Following
treatment, both the study groups showed a reduction in vagal tone together
with a decrease in the sympathetic activity. There was also a considerable
relief of pain in both groups, however, the acupuncture group showed a
better response (P<0.01). We conclude that there is autonomic dysfunction
in chronic LBP patients. Acupuncture effectively relieves the pain and
improves the autonomic status and hence can be used as an alternative/
additive treatment modality in these cases.
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Keywords
chronic low back pain, autonomic status, pain profile, electro acupuncture
Citation
Shankar Nilima, Thakur Manisha, Tandon Om Prakash, Saxena Ashok Kumar, Arora Shobha, Bhattacharya Neena. Autonomic status and pain profile in patients of chronic low back pain and following electro acupuncture therapy: A randomized control trial. Indian Journal of Physiology and Pharmacology. 2011 Jan-Mar; 55(1): 25-36.