Key Points

Question  Is acupuncture needling (both a standard acupuncture course and additional maintenance sessions) an effective treatment for older adults with chronic low back pain (CLBP)?

Findings  In this randomized clinical trial that included 800 older adults with CLBP, acupuncture needling (both a standard course and additional maintenance sessions) improved pain-related disability with CLBP at 6 months and 12 months, with no statistically discernible benefit of additional maintenance sessions.

Meaning  These findings suggest that acupuncture needling is an effective and safe treatment option for older adults with CLBP. Importance  The study was carried out to inform Medicare acupuncture coverage decisions addressing the gap in evidence on acupuncture effectiveness, specifically for older adults with chronic low back pain (CLBP).

Objective  To determine the effectiveness of standard acupuncture (SA) or SA plus maintenance (enhanced acupuncture [EA]) to improve CLBP-related disability relative to usual medical care (UMC) at 3, 6, and 12 months after randomization.

Conclusions and Relevance  The findings of this randomized clinical trial of older adults with CLBP suggest that acupuncture needling provided greater improvements in back pain–related disability at 6 months and at 12 months compared with UMC alone. These findings support acupuncture needling as an effective and safe treatment option for older adults with CLBP.

Trial Registration  ClinicalTrials.gov Identifier: NCT04982315