Efficacy and Safety of Acupuncture versus Sham in Patients with Chronic Sciatica: A Systematic review and Meta-analysis with GRADE assessment

Efficacy and Safety of Acupuncture versus Sham in Patients with Chronic Sciatica: A Systematic review and Meta-analysis with GRADE assessment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Efficacy and Safety of Acupuncture versus Sham in Patients with Chronic Sciatica: A Systematic review and Meta-analysis with GRADE assessment Yahya A. Mahmoud, Amr Mohamed Shawkat, Monzer Elhussein, Areen Anwer Melhem, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6797552/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Chronic sciatica is associated with persistent pain and functional impairment. Acupuncture has emerged as a promising non-pharmacological approach for chronic sciatica. This review aimed to assess the efficacy and safety of acupuncture versus sham acupuncture in patients with chronic sciatica. Methods Following the PRISMA guidelines, we systematically searched PubMed, Scopus, Cochrane Library, and Web of Science up to March 23, 2025. Randomized controlled trials comparing acupuncture to sham in chronic sciatica were included. Primary outcomes included pain reduction measured by VAS and functional improvement assessed by ODI. Secondary outcomes included SFBI and SF-36. Risk of bias was evaluated using ROB-2, meta-analyses were performed using RevMan 5.4, and the certainty of evidence of each pooled analysis was rated according to GRADE . Results Four RCTs involving 385 participants were included. Pooled data demonstrated significant short-term benefits of acupuncture over sham in reducing both leg and back pain, particularly by week 2 and peaking at week 4. Functional improvement as measured by ODI was also significantly better in the acupuncture group at week 4. Acupuncture reduced SFBI frequency and bothersomeness scores and marginally improved SF-36 physical health outcomes. However, long-term effects at weeks 16, 28, and 52 were inconsistent. Adverse events were minimal and self-limiting, and acupuncture showed a favorable safety profile. Conclusion Acupuncture is a safe and effective complementary therapy for managing chronic sciatica, offering superior short-term pain relief and functional improvement compared to sham acupuncture. However, the durability of these effects beyond one month remains unclear. Further high-quality trials with longer follow-up periods are needed to substantiate its long-term efficacy. Chronic sciatica acupuncture sham acupuncture pain management functional improvement Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryofEfficacyandSafetyofAcupunctureversusShaminPatientswithChronicSciaticaASystematicreviewandMetaanalysiswithGRADEassessment.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6797552","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":464872024,"identity":"e96fbae1-a101-43c1-879a-6cff00679ea0","order_by":0,"name":"Yahya A. 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improvement","lastPublishedDoi":"10.21203/rs.3.rs-6797552/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6797552/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eChronic sciatica is associated with persistent pain and functional impairment. Acupuncture has emerged as a promising non-pharmacological approach for chronic sciatica. This review aimed to assess the efficacy and safety of acupuncture versus sham acupuncture in patients with chronic sciatica.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e Following the PRISMA guidelines, we systematically searched PubMed, Scopus, Cochrane Library, and Web of Science up to March 23, 2025. Randomized controlled trials comparing acupuncture to sham in chronic sciatica were included. Primary outcomes included pain reduction measured by VAS and functional improvement assessed by ODI. Secondary outcomes included SFBI and SF-36. Risk of bias was evaluated using ROB-2, meta-analyses were performed using RevMan 5.4, and the certainty of evidence of each pooled analysis was rated according to GRADE .\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFour RCTs involving 385 participants were included. Pooled data demonstrated significant short-term benefits of acupuncture over sham in reducing both leg and back pain, particularly by week 2 and peaking at week 4. Functional improvement as measured by ODI was also significantly better in the acupuncture group at week 4. Acupuncture reduced SFBI frequency and bothersomeness scores and marginally improved SF-36 physical health outcomes. However, long-term effects at weeks 16, 28, and 52 were inconsistent. Adverse events were minimal and self-limiting, and acupuncture showed a favorable safety profile.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eAcupuncture is a safe and effective complementary therapy for managing chronic sciatica, offering superior short-term pain relief and functional improvement compared to sham acupuncture. However, the durability of these effects beyond one month remains unclear. Further high-quality trials with longer follow-up periods are needed to substantiate its long-term efficacy.\u003c/p\u003e","manuscriptTitle":"Efficacy and Safety of Acupuncture versus Sham in Patients with Chronic Sciatica: A Systematic review and Meta-analysis with GRADE assessment","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-04 18:54:53","doi":"10.21203/rs.3.rs-6797552/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c0747cee-f752-440b-a023-550e82d4a47e","owner":[],"postedDate":"June 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-17T15:38:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-04 18:54:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6797552","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6797552","identity":"rs-6797552","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}