Effect of Auriculotherapy on Sleep Quality in Elderly with Chronic Low Back Pain: A Single-blind Randomized Clinical Trial

Introduction: One of the common problems that leads to poor sleep quality in the elderly is low back pain. This study aims to evaluate the effect of auriculotherapy (ear acupressure) on the sleep quality of elderly people with chronic low back pain. Methods: This single-blind randomized clinical trial was conducted in 2019 on 70 older adults with chronic low back pain in Kashan, Iran, who were selected using a convenience sampling technique. After obtaining a written informed consent, they were assigned into intervention and sham groups using the block randomization method. In the intervention group, the pressure was applied to ShenMen, sympathetic, subcortex and low back points of the ear, while in the sham group, the pressure was applied to the points that were not associated with the low back pain. The Pittsburgh Sleep Quality Index (PSQI) and McGill Pain Questionnaire (MPQ) were completed at the beginning of the study, at the end of intervention, and one month after the end of intervention. Six patients from the Sham group and 2 patients from the intervention group were excluded from the study. The data of 62 subjects were analyzed using ANCOVA and repeated measures ANOVA using Per-Protocol (PP) and Intention-To-Treat (ITT) approaches. Results:  There was a statistically significant difference between the intervention and sham groups in terms of the duration of disease at baseline (P=0.012). The interaction effect of time and group on the sleep quality was significant (P<0.0001).  Sleep quality in the intervention group was significantly better than in the sham group at the end of the intervention and also during the one-month follow-up period (P<0.0001). Within-group comparison results reported a significant difference in the sleep quality between three evaluation times in the intervention group (P<0.0001). Conclusion: Auriculotherapy can improve sleep quality in the elderly with chronic low back pain. It is recommended to use auriculotherapy as a complementary therapy for treating these elderly groups.