Classical Massage and Acupuncture in Chronic Back Pain - Non-Inferiority Randomised Trial.

Area of Science:

• Complementary and Alternative Medicine
• Pain Management
• Evidence-Based Practice

Background:

• Need for evidence on classical massage therapy (KMT) for chronic back pain, focusing on functional improvement and long-term pain reduction.
• Current guidelines recommend KMT only with exercise, unlike acupuncture (AKU), which is an independent, reimbursed treatment.
• A randomized controlled non-inferiority study was conducted to objectively assess KMT's efficacy compared to AKU.

Purpose of the Study:

• To determine if classical massage therapy (KMT) is non-inferior to acupuncture therapy (AKU) for chronic back pain.
• To compare the efficacy of KMT and AKU in improving functional impairment and reducing pain.
• To provide scientific evidence for KMT's role in managing chronic back pain.

Main Methods:

• A randomized controlled non-inferiority trial comparing KMT (n=66) and AKU (n=66) for chronic back pain.
• Primary endpoint: non-inferiority of KMT to AKU regarding functional impairment (Hannover Function Questionnaire) and pain reduction ('Von Korff' Questionnaire) at one-month follow-up.
• Per-protocol analysis was used to evaluate responder rates.

Main Results:

• The responder rate for KMT was 56.5%, compared to 62.5% for AKU.
• This indicates a tendency towards KMT being inferior to AKU, with a difference of -6% (95% CI: -23.5% to +11.4%).
• The study did not demonstrate statistical non-inferiority of KMT to AKU within the predefined margin.

Conclusions:

• Classical massage therapy (KMT) was not found to be significantly inferior to acupuncture therapy (AKU) in the short term.
• However, the non-inferiority of KMT compared to AKU could not be definitively proven within the defined limits of clinical relevance.
• Further research may be needed to fully elucidate the comparative efficacy of KMT and AKU for chronic back pain.