Reviews of published studies on current topics in sports medicine. The full articles can be obtained from hospital and medical school libraries. To order complete Sports Reports online for these topics and more complete our online form.

ACUPUNCTURE AS THERAPY FOR CHRONIC PAIN

Numerous studies of acupuncture have revealed it to be a viable and efficacious therapy for the treatment of chronic pain. Subjects with chronic conditions such as low back pain, neck pain, and tennis elbow have used acupuncture to relieve pain intensity, improve sleep, and increase functionality [1, 2, 3]. Some authors have demonstrated that the effects of acupuncture may be due to patient expectations [4] or a more general placebo effect [6]. Others have shown that needling is important to the treatment, although the effects of choosing specific points remain unclear [5]. However, all the studies reviewed below conclude that, for whatever reason, acupuncture can be an effective and safe supplemental therapy for chronic pain management.

1. Carlsson CPO, Sjslund BH. Acupuncture for chronic low pack pain: a randomized placebo-controlled study with long-term follow-up. The Clinical Journal of Pain 2001:17:4:296-305.

Fifty subjects with chronic low-back pain were treated with acupuncture therapy or active placebo once a week for a period of eight weeks. During a follow-up period of six months, subjects received two additional treatments and were also assessed by an independent observer. Subjects also kept individual pain diaries that recorded analgesic intake, pain intensity, quality of sleep, and activity level. Results showed that fourteen out of thirty-four subjects receiving acupuncture reported improvement that lasted during the entire six months, while only two out of fourteen control subjects reported similar improvement. Specifically, acupuncture patients reported significant decreases in pain intensity, as well as improvements in sleep, analgesic intake, and ability to work by one to three months into the follow-up period. Authors conclude that needle acupuncture appears to provide long-term pain relief to some patients with chronic low back pain.

TREATMENT ISSUES FOR ANTERIOR CRUCIATE LIGAMENT (ACL) INJURIES

When a tear of the ACL has been diagnosed in an athlete, several decisions need to be addressed. The first decision is whether to proceed with surgery or attempt rehabilitation without surgery. If the decision is made to have surgical treatment, questions arise as to the best type of surgery for that individual, the long-term outlook after surgery, and types of rehabilitation after surgery. The following are the author’s summaries of recently published medical studies that address these questions. The complete articles can be found at most hospital, medical school, or university libraries. The summaries are presented for educational purposes only and are not in any way a substitute for medical evaluation and treatment.

1. Mark D. Shaieb, Darryl M. Kan, Spencer K. Chang, Jay M. Marumoto, Allen B. Richardson. A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction . The American Journal of Sports Medicine, March-April 2002 v30 i2 p214(7).

A comparison of patellar tendon versus hamstring tendon for ACL reconstruction. Study was on 70 patients, all surgery performed by the same surgeon. At two year follow-up, 97% of patients with patellar tendon grafts and 100% of patients with hamstring tendon grafts rated the results as good or excellent. No significant differences between groups in terms of activity level or physical findings. Patellar tendon patients had higher likelihood of patellar-femoral pain at six months and longer follow-up (42% versus 20% in the hamstring group). There were two graft failures in each group.