Table 4: Therapeutic outcomes of randomized controlled trials on AA for chronic LBP.

StudiesMain outcome measureMain resultsAdverse events

Lu et al. 2015(1) Pain intensity (VAS)
(2) The total effective rate
(1) Significant decrease, P < 0.05; E: pre-AA 5.37 ± 1.85, post-AA 2.49 ± 1.66; C: pre-Rx 5.42 ± 2.13, post-Rx 3.56 ± 1.74
(2) Significant difference, P < 0.05; E: 91.89% versus C: 81.08%
None
Suen et al. 2007(1) Pain intensity (VRS)(1) Significant improvement, P < 0.001; E: pre-AA 2.73 ± 0.74, post-AA 1.87 ± 0.68; C: pre-Rx 2.47 ± 0.78, post-Rx 2.27 ± 0.58; significant difference between baseline and the other time points (therapy completed, 2-week follow-up, 4-week follow-up) in E group, P < 0.001, E: 2-week follow-up, 2.07 ± 0.69, versus 4-week follow-up, 2.20 ± 0.55NM
Wang 2015(1) Pain intensity (VAS)
(2) The total effective rate
(1) Significant decrease, P < 0.05; E: pre-AA 5.24 ± 1.91, post-AA 2.36 ± 1.43; C: pre-Rx 5.31 ± 2.05, post-Rx 3.52 ± 1.76; significant improvement in E and C within groups (P < 0.05)
(2) Significant difference, P < 0.05; E: 93.1% versus C: 82.8%
NM
Xia et al. 2011(1) Pain intensity (SFMPQ, consisting of PRI, VAS, and PPI)(1) Significant difference after 3-day and 2-week treatment in PRI, P < 0.05; E: pre-AA 13.76 ± 5.49, post-AA (3-day) 10.92 ± 4.95, post-AA (2-week) 6.25 ± 2.17; C: pre-Rx 13.92 ± 5.25, post-Rx (3-day) 12.98 ± 4.87, post-AA (2-week) 7.56 ± 2.31; significant difference after 3-day treatment in VAS, P < 0.05; E: pre-AA 5.79 ± 2.06, post-AA (3-day) 4.75 ± 1.69; C: pre-Rx 5.86 ± 1.89, post-Rx (3-day) 5.09 ± 1.51; significant difference after 3-day treatment in PPI, P < 0.05; E: pre-AA 3.82 ± 1.24, post-AA (3-day) 2.92 ± 1.17; C: pre-Rx 3.53 ± 1.12, post-Rx (3-day) 3.25 ± 1.2014 had mild, tolerable, and short-term itchiness (E: 6, C: 8); 5 in E group felt obvious but tolerable pain of the ears after adopting AA
Yeh et al. 2013(1) Pain intensity (BPI, consisting of worst pain, average pain, and overall pain intensity)
(2) Physical functioning (RMDQ)
(1) Significant decrease in “worst pain” between E and C at end of intervention and 1-month follow-up, P < 0.01; E: pre-AA 5.40 ± 0.97, post-AA 1.60 ± 1.71, follow-up 1.40 ± 1.43; C: pre-Rx 5.88 ± 1.89, post-Rx 4.38 ± 1.06, follow-up 4.14 ± 1.86; The scores of “average pain” and “overall pain severity” had a similar change in pattern
(2) No significant decrease in physical function which was in expected direction, P > 0.05; E: pre-AA 3.30 ± 2.54, post-AA 1.67 ± 1.32, follow-up 1.90 ± 1.66; C: pre-Rx 7.75 ± 6.23, post-Rx 7.00 ± 6.74, follow-up 6.13 ± 5.28
Both groups experienced sensitivity ( = 3), soreness ( = 4), discomfort ( = 4), itching on the ear (), and sleep disturbance (), but all were tolerable
Yeh et al. 2014(1) Pain intensity
(2) Physical functioning (RMDQ)
(1) Significant decrease in “worst pain” at end of intervention and 1-month follow-up, P < 0.01; E: pre-AA 7.32 ± 2.03, post-AA (−3.00), follow-up (−3.16); C: pre-Rx 7.28 ± 1.90, post-Rx (−0.33), follow-up (−0.06)
(2) Significant decrease in physical function, P < 0.01; E: pre-AA 11.11 ± 6.11, post-AA (−2.95), follow-up (−2.63); C: pre-Rx 14.11 ± 4.57, post-Rx (−0.11), follow-up (−0.33)
Both groups experienced sensitivity ( = 3), soreness ( = 4), discomfort ( = 4), itching on the ear (), and sleep disturbance ( = 2), but all were tolerable
Yeh et al. 2015(1) Pain intensity (BPI, consisting of worst pain, average pain, and overall pain intensity)
(2) Change over time in daily worst pain intensity
(3) Relationship of seed pressing time, frequency, and analgesic use to pain intensity change
(1) Significant decrease in “worst pain” between E and C at end of intervention, < 0.01; E: pre-AA 6.90 ± 1.85, post-AA 3.81 ± 3.12; C: pre-Rx 7.13 ± 1.87, post-Rx 6.13 ± 2.93; greatest reduction was recorded in “average pain” in E group: pre-AA 6.87 ± 1.82, post-AA 2.85 ± 2.54
(2) The mean score of worst pain decreased 30.0% after the first day of AA, reached the largest decrease (50.08%) at day 24, and eventually settled at a 47.67% reduction at day 28; three significant changes occurred, respectively, at day 1, day 5, and day 8
(3) Total pressing time, average minutes per pressing, and analgesic use developed a statistically significant association with worst pain intensity (each 1-minute increase in pressing the seeds significantly reduced the worst pain score by 0.04; each 1-minute increase in total amount of time in which the seeds were pressed significantly reduced average pain by 0.05)
11 had soreness and tenderness of the ear and 3 had irritation and sensitization caused by the adhesive tape

AA, auricular acupressure; LBP, low back pain; VAS, Visual Analogue Scale; E, experimental group; C, control group; VRS, Verbal Rating Scale (VRS-Chinese); NM, not mentioned; Rx, treatment; SFMPQ, Short-Form McGill Pain Questionnaire; PRI, pain rating index; VAS, Visual Analogue Scale; PPI, present pain intensity; BPI, Brief Pain Inventory (short form); RMDQ, Roland-Morris Disability Questionnaire.