title: Day-to-Day Changes of Auricular Point Acupressure to Manage Chronic Low Back Pain: A 29-day Randomized Controlled Study.
abstract: OBJECTIVE
  The purpose of this study was to determine the effects of a 4-week auricular point acupressure (APA) treatment on chronic low back pain (CLBP) outcomes and examine the day-to-day variability of CLBP in individuals receiving APA for CLBP over 29 days.
  
  
  METHODS
  This was a prospective, randomized controlled trial (RCT). Data were collected at baseline, during each of the four office visits for APA treatment, after the completion of the 4-week intervention, and 1 month after the last treatment. A daily diary was given to each participant to record his or her APA practices, analgesic use, and pain intensity.
  
  
  METHODS
  APA was used to manage CLBP. The participants received one APA treatment per week for 4 weeks.
  
  
  METHODS
  Sixty-one participants with CLBP were randomized into either a real APA or sham APA treatment group. Participants were recruited from primary care offices and clinics or through the Research Participant Registry at the University of Pittsburgh.
  
  
  RESULTS
  Among participants in the real APA group, a 30% reduction of worst pain was exhibited after the first day of APA treatment, and continuous reduction in pain (44%) was reported by the completion of the 4-week APA. This magnitude of pain reduction reached the clinically significant level of improvement reported in other clinical trials of chronic pain therapies. Analgesic use by participants in the real APA group also was reduced compared with use by participants in the sham group.
  
  
  CONCLUSIONS
  This study shows that APA is a promising pain management strategy that is not invasive and can be self-managed by participants for CLBP. Given the day-to-day fluctuation in ratings, the tighter ecologic assessment of pain scores and other treatment parameters are an important pragmatic aspect of the design of chronic pain studies.
authors.affiliation: School of Nursing, University of Pittsburgh.
authors.forename: Chao Hsing
authors.initials: CH
authors.lastname: Yeh
authors.affiliation: School of Nursing, Hong Kong Polytechnic University.
authors.forename: Lorna
authors.initials: L
authors.lastname: Kwai-Ping Suen
authors.affiliation: Department of Biostatistics, School of Public Health at San Antonio Regional Campus, Research to Advance Community Health Center, University of Texas Health Science Center at San Antonio Regional Campus.
authors.forename: Lung-Chang
authors.initials: LC
authors.lastname: Chien
authors.affiliation: School of Nursing, University of Pittsburgh.
authors.forename: Leah
authors.initials: L
authors.lastname: Margolis
authors.affiliation: School of Nursing, University of Pittsburgh.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh.|Department of Physical Medicine, School of Medicine, University of Pittsburgh.|Department of Rehabilitation, School of Medicine, University of Pittsburgh.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Glick
authors.affiliation: Department of Medicine, Division of General Internal Medicine, Veterans Administration, Pittsburgh Healthcare System, Geriatric Research Education and Clinical Center, School of Medicine, University of Pittsburgh.
authors.forename: Natalia E
authors.initials: NE
authors.lastname: Morone
mesh_terms: D019050:Acupressure / Q000379:methods*; D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000175:diagnosis* / Q000628:therapy*; D054644:Ear Auricle; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016896:Treatment Outcome; D055815:Young Adult
keywords: Analgesic Use; Auricular Point Acupressure; Chronic Low Back Pain; Pain Intensity