{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:07:38Z","timestamp":1793333258302,"version":"4.5.0"},"reference-count":46,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"No funding was received for this study"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2025,11,21]]},"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>\n                    <jats:italic>Introduction<\/jats:italic>\n                    : Chronic low back pain (CLBP) is a leading global cause of disability. Acupuncture is increasingly integrated into its management, yet its standalone effectiveness compared to usual care remains uncertain. This review aimed to assess the immediate (\u22642 weeks) and intermediate (2 weeks\u20136 months) effects of acupuncture versus usual care on pain and disability in adults with CLBP.\n                    <jats:italic>Methods<\/jats:italic>\n                    : A systematic review and meta-analysis of randomized controlled trials was conducted, searching MEDLINE, CENTRAL, Scopus, and PEDro through November 2024. Eligible studies compared acupuncture (body, electroacupuncture, scalp) to usual care (physiotherapy, education, medication, and exercise) in adults with CLBP. Outcomes included pain and disability at immediate and intermediate follow-up. Data were pooled using a random-effects model. Risk of bias was assessed with the PEDro scale, and GRADE was used to evaluate evidence certainty. Sensitivity and subgroup analyses were conducted to explore clinical and methodological heterogeneity and test the reliability of findings.\n                    <jats:italic>Results<\/jats:italic>\n                    : A total of 2.956 records were identified, and 8 RCTs (\n                    <jats:italic>n<\/jats:italic>\n                    = 1,123 participants) were included in this study. Acupuncture significantly reduced pain at both immediate (SMD = \u20130.73, 95% CI \u20131.04 to \u20130.42) and intermediate (SMD = \u20131.13, 95% CI \u20131.82 to \u20130.43) timepoints. Disability also improved at both follow-ups (immediate: SMD = \u20130.49, 95% CI \u20130.68 to \u20130.30 and intermediate: SMD = \u20130.79, 95% CI \u20131.18 to \u20130.41). Sensitivity analyses confirmed effect robustness, especially in electroacupuncture subgroups. Certainty of evidence ranged from low to very low due to risk of bias, inconsistency, and suspected publication bias.\n                    <jats:italic>Discussion<\/jats:italic>\n                    : Acupuncture appears more effective than usual care for reducing pain and disability in adults with CLBP, but the certainty of evidence is low, warranting cautious interpretation.\n                  <\/jats:p>","DOI":"10.1051\/sicotj\/2025061","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T08:50:36Z","timestamp":1770108636000},"page":"7","source":"Crossref","is-referenced-by-count":1,"title":["Acupuncture vs usual care for chronic low back pain: a systematic review and meta-analysis of immediate and intermediate effects"],"prefix":"10.1051","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8403-4610","authenticated-orcid":false,"given":"Spyridon","family":"Sotiropoulos","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, University of West Attica","place":["Greece"]},{"name":"Musculoskeletal Physiotherapy Research Laboratory, University of West Attica","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3115-2281","authenticated-orcid":false,"given":"Eleftherios","family":"Kalafatis","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of West Attica","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6734-3365","authenticated-orcid":false,"given":"Evaggelos","family":"Michalakakos","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of West Attica","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0807-0719","authenticated-orcid":false,"given":"Andreas","family":"Mavrogenis","sequence":"additional","affiliation":[{"name":"1st Department of Anesthesia, Aretaieion University Hospital, National and Kapodistrian University of Athens","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3274-8251","authenticated-orcid":false,"given":"George","family":"Georgoudis","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of West Attica","place":["Greece"]},{"name":"Musculoskeletal Physiotherapy Research Laboratory, University of West Attica","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","volume":"392","author":"James","year":"2018","journal-title":"Lancet"},{"key":"R2","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","volume":"391","author":"Hartvigsen","year":"2018","journal-title":"Lancet"},{"key":"R3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.spinee.2007.10.005","volume":"8","author":"Dieleman","year":"2008","journal-title":"Spine J"},{"key":"R4","first-page":"646","volume":"81","author":"Woolf","year":"2003","journal-title":"Bull World Health Organ"},{"key":"R5","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1016\/S0140-6736(18)30489-6","volume":"391","author":"Foster","year":"2018","journal-title":"Lancet"},{"key":"R6","unstructured":"Chou R, Deyo R, Friedly J, et al. (2016) Noninvasive treatments for low back pain. Rockville (MD), Agency for Healthcare Research and Quality."},{"key":"R7","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/M16-2367","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"key":"R8","first-page":"e84342","volume":"17","author":"Sotiropoulos","year":"2025","journal-title":"Cureus"},{"key":"R9","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2016.1464","volume":"315","author":"Dowell","year":"2016","journal-title":"JAMA"},{"key":"R10","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jpain.2017.11.005","volume":"19","author":"Vickers","year":"2018","journal-title":"J Pain"},{"key":"R11","unstructured":"National Institute for Health and Care Excellence (2020) Low back pain and sciatica in over 16s: assessment and management (NG59). London, National Institute for Health and Care Excellence."},{"key":"R12","first-page":"CD013814","volume":"12","author":"Mu","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"R13","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1089\/acu.2021.0057","volume":"34","author":"Asano","year":"2022","journal-title":"Med Acupunct"},{"key":"R14","doi-asserted-by":"crossref","first-page":"100972","DOI":"10.1016\/j.imr.2023.100972","volume":"12","author":"Giovanardi","year":"2023","journal-title":"Integr Med Res"},{"key":"R15","doi-asserted-by":"crossref","first-page":"11546","DOI":"10.1038\/s41598-024-62276-9","volume":"14","author":"Baroncini","year":"2024","journal-title":"Sci Rep"},{"key":"R16","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R17","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"R18","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1093\/ptj\/83.8.713","volume":"83","author":"Maher","year":"2003","journal-title":"Phys Ther"},{"key":"R19","unstructured":"World Health Organization (2014) WHO handbook for guideline development, 2nd ed., Geneva, World Health Organization."},{"key":"R20","unstructured":"Higgins JPT, Thoma J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (2024) Cochrane handbook for systematic reviews of interventions version 6.5 (updated August 2024), Cochrane."},{"key":"R21","unstructured":"Manager Review (2024) RevMan 2024, Cochrane Collaboration, London."},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Deeks JJ, Higgins JP, Altman DG, Cochrane Statistical Methods Group (2019) Analysing data and undertaking meta-analyses, in Cochrane handbook for systematic reviews of interventions. Chichester, John Wiley & Sons Ltd, 241\u2013284.","DOI":"10.1002\/9781119536604.ch10"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Higgins JP, Savovi\u0107 J, Page MJ, Elbers RG, Sterne JA (2019) Assessing risk of bias in a randomised trial, in Cochrane handbook for systematic reviews of interventions. Chichester, John Wiley & Sons Ltd, 205\u2013228.","DOI":"10.1002\/9781119536604.ch8"},{"key":"R24","doi-asserted-by":"crossref","unstructured":"Page MJ, Higgins JP, Sterne JA (2019) Assessing risk of bias due to missing results in a synthesis, in Cochrane handbook for systematic reviews of interventions. Chichester, John Wiley & Sons Ltd, 349\u2013374.","DOI":"10.1002\/9781119536604.ch13"},{"key":"R25","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"R26","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1001\/Archinte.167.17.1892","volume":"167","author":"Haake","year":"2007","journal-title":"Arch Intern Med"},{"key":"R27","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1749-8546-5-15","volume":"5","author":"Zaringhalam","year":"2010","journal-title":"Chin Med"},{"key":"R28","first-page":"25","volume":"55","author":"Shankar","year":"2011","journal-title":"Indian J Physiol Pharmacol"},{"key":"R29","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1590\/0103-5150.028.004.AO09","volume":"28","author":"Camilotti","year":"2015","journal-title":"Fisioter Mov"},{"key":"R30","doi-asserted-by":"crossref","first-page":"945210","DOI":"10.3389\/fneur.2022.945210","volume":"13","author":"Meng","year":"2022","journal-title":"Front Neurol"},{"key":"R31","doi-asserted-by":"crossref","first-page":"e34407","DOI":"10.1097\/MD.0000000000034407","volume":"102","author":"Cheng","year":"2023","journal-title":"Med (Baltimore)"},{"key":"R32","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1097\/MS9.0000000000001944","volume":"86","author":"Jamali Dastjerdi","year":"2024","journal-title":"Ann Med Surg (Lond)"},{"key":"R33","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1177\/02692155231201589","volume":"38","author":"Lara-Palomo","year":"2024","journal-title":"Clin Rehabil"},{"key":"R34","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/j.1365-2753.2008.00986.x","volume":"14","author":"Ioannidis","year":"2008","journal-title":"J Eval Clin Pract"},{"key":"R35","doi-asserted-by":"crossref","unstructured":"Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Introduction to meta-analysis. Chichester, John Wiley & Sons.","DOI":"10.1002\/9780470743386"},{"key":"R36","first-page":"780","volume":"32","author":"Qin","year":"2024","journal-title":"Support Care Cancer"},{"key":"R37","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0304-3959(01)00349-9","volume":"94","author":"Farrar","year":"2001","journal-title":"Pain"},{"key":"R38","doi-asserted-by":"crossref","first-page":"371","DOI":"10.4065\/77.4.371","volume":"77","author":"Guyatt","year":"2002","journal-title":"Mayo Clin Proc"},{"key":"R39","first-page":"582","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care"},{"key":"R40","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1051\/sicotj\/2018029","volume":"4","author":"MacCormick","year":"2018","journal-title":"SICOT J"},{"key":"R41","doi-asserted-by":"crossref","first-page":"429","DOI":"10.7326\/0003-4819-157-6-201209180-00537","volume":"157","author":"Savovi\u0107","year":"2012","journal-title":"Ann Intern Med"},{"key":"R42","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"R43","doi-asserted-by":"crossref","first-page":"d4002","DOI":"10.1136\/bmj.d4002","volume":"343","author":"Sterne","year":"2011","journal-title":"BMJ"},{"key":"R44","doi-asserted-by":"crossref","first-page":"e124","DOI":"10.1371\/journal.pmed.0020124","volume":"2","author":"Ioannidis","year":"2005","journal-title":"PLoS Med"},{"key":"R45","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/S0140-6736(97)02419-7","volume":"350","author":"Egger","year":"1997","journal-title":"Lancet"},{"key":"R46","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1017\/S0266462312000086","volume":"28","author":"Morrison","year":"2012","journal-title":"Int J Technol Assess Health Care"}],"container-title":["SICOT-J"],"original-title":[],"link":[{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2025061\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T08:50:58Z","timestamp":1770108658000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2025061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":46,"alternative-id":["sicotj250093"],"URL":"https:\/\/doi.org\/10.1051\/sicotj\/2025061","relation":{},"ISSN":["2426-8887"],"issn-type":[{"value":"2426-8887","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}