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Published online 2012 Feb 21. doi:  10.1186/2045-709X-20-3

Table 2

Acupuncture and related modalities for the treatment of CLBP

ModalityIndicationsContraindications (relative)Potential Adverse Effects
Traditional Chinese Acupuncture (TCA)Insufficient clinical trials evidence to recommend for older adults with CLBP• Bleeding diathesis
• Pacemaker (if leads cross chest when using electrical stimulation)
• Severely immune-compromised state
• Bleeding, bruising
• Infection (very rare)
• Transient pain flare
• Transient fatigue
• Vasovagal response

Percutaneous electrical nerve stimulation (PENS)CLBP in older adults; minimum effective dose of electrical stimulation unknownAs with TCAAs with TCA

Auricular acupunctureInsufficient clinical trials evidence to recommend for older adults with CLBP; theoretically useful for augmenting corporeal treatments.• Bleeding diathesis
• Cartilage disease (e.g., relapsing polychondritis)
As with TCA

Trigger point deactivationMyofascial pain; local twitch response is essential therapeutic element (ref). May be combined with other acupuncture modalities, e.g., following PENS for recalcitrant localized pain.As with TCAAs with TCA; as compared with TCA and PENS, trigger point deactivation may be painful.

Deep intramuscular electrical stimulationLocalized myofascial pathology (e.g., piriformis, erector spinae); may be performed in addition to TCA or PENS for recalcitrant localized myofascial pain.As with TCAAs with TCA