Willingness to try acupuncture again: reports from patients on their treatment reactions in a low back pain trial

Reactions to treatment are common following acupuncture. Understanding how these reactions are interpreted by patients is largely unexplored.

To examine patients ratings of the severity and bothersomeness of a range of common treatment reactions, and to assess their impact on willingness to try acupuncture again.

Self-reported ratings of the frequency, severity and bothersomeness of treatment reactions from 133 patients in the acupuncture arm of a pragmatic randomised controlled trial of acupuncture for chronic back pain are described and analysed.

A total of 133 acupuncture patients reported at3 months reactions that they had experienced at anytime during a course of up to 10 acupuncture treatment sessions. They received a total of 1150 treatments, an average of 8.6 sessions per patient. All patients reported treatment reactions, most commonly relaxation (84%,n = 112), which was significantly associated with willingness to try acupuncture again, (χ2 = 7.860,df = 1, p = 0.005). Only 16% (n=21) were unwilling to experience a specific treatment reaction again, and 9%(n = 12) were unwilling to try acupuncture again. The most bothersome reaction was a temporary worsening of symptoms (29%, n=38), though this was not associated with an unwillingness to try acupuncture again (χ2 = 0.382, df = 1, p>0.536). Those unwilling to try acupuncture again reported significantly less reduction in their pain at 3 months (mean (SE) SF-36 bodily pain score at 3 months 30.453 (3.598) vs 19.30(1.128); p=0.003).

Among this group of patients seeking help for low back pain, the experience of treatment reactions was universal. There was no evidence that the bothersomeness of treatment reactions was associated with patient's willingness to try acupuncture again. The benefit of pain reduction over the course of treatment appeared to outweigh self-rated bothersome reactions to treatment.