Acupressure for Fatigue and Low Back Pain

Acupressure is a Traditional Chinese Medicine (TCM) technique based on a philosophy similar
to that of acupuncture. It involves the application of physical pressure on different
acupuncture points (acupoints). One advantage of acupressure is the ability to
self-administer the treatment. Acupressure is also a viable alternative to acupuncture in
situations where patients: (1) cannot come to the clinic to receive an acupuncture
treatment; (2) when a more frequent intervention is needed; or (3) where needle phobia or
safety concerns are an issue.

The objective of this study is to evaluate the validity and feasibility of teaching
acupressure interventions using an acupressure educator for the management of symptoms
related to low back pain.

Specific aims:

1. To examine the effect of 6-weeks of relaxation acupressure (RA) compared to a regime of
stimulating acupressure (SA) or wait-list control (WL) on fatigue and sleep quality as
assessed by Brief Fatigue Inventory and wrist-worn accelerometry (sleep efficiency).

2. To explore the effect of 6-weeks of RA compared to a regime of SA or WL on for chronic
low back pain in terms of reduced pain and improved function.

Inclusion Criteria:

- Aged18-65 years

- Non-specific low back pain (either by self-report or via ICD-9 codes 724.2, 724.5,
846.0-846.9)

- Low back pain that has persisted for at least 3 months

- Minimum of 3/10 on the Pain Bothersome Scale

- Minimum of 3/10 fatigue severity

- Ambulatory with or without assistive device

- Ability to operate the accelerometer (Actiwatch-S)

- Stable medication regiment for the previous 2 months

- Report of a physician's visit during the previous 24 months

- English-speaking

Exclusion Criteria:

- Medically unstable (acute conditions or acute presentations of chronic conditions)

- Current pregnancy

- Radiculopathy or report of low back pain radiating to below the knee

- Reported history of spinal fracture, herniated lumbar disc, ankylosing spondylitis,
and spinal stenosis.

- Report of back surgery within the preceding 12 months

- Participation in active litigation or compensation claims

- Conditions that might confound treatment effects or interpretation of results (for
example, rheumatoid arthritis, lupus)

- Acupuncture or acupressure within the preceding 12 months

- Report of sleep apnea

- 2nd or 3rd shift workers or other non-traditional sleep schedules

- Use of anti-coagulant/platelet therapy within the preceding month