Introduction
Chronic low back pain (CLBP) represents a major public health concern, particularly among older adults where its prevalence exceeds one-third of the population aged 65 years and older.1,3 This condition contributes significantly to pain-related disability worldwide and leads to high economic costs, with expenditures surpassing $134 billion annually in the United States alone.5 Conventional treatments, primarily pharmacologic and invasive modalities, have had limited long-term impact on improving functional outcomes in this demographic.6-13 The risk of adverse events related to polypharmacy in older adults further underscores the need for low-risk, nonpharmacologic management strategies.16-20
Acupuncture has demonstrated efficacy for CLBP and is endorsed as a first-line nonpharmacological treatment by guidelines such as those from the American College of Physicians.24,25 Moreover, acupuncture is associated with improvements in sleep quality and emotional well-being — common concerns in older populations with CLBP.28-30 However, there has been a lack of large-scale randomized clinical trials specifically targeting older adults, and optimal dosing strategies remain uncertain.