Back pain, especially low back pain, is a significant health problem. According to the National Institutes of Health, eight out of 10 people will have back pain at some time in their lives. Also, back pain is the most frequent cause of activity limitations in people under 45.
Several recent studies done in both Europe and America have suggested that acupuncture is an effective treatment for chronic low back pain. I found the most recent, a study conducted in Washington and California, to be particularly interesting. Following a description of the study and its results, I'll share my thoughts on the conclusion.
A total of 638 adults with uncomplicated chronic low back pain participated in this study. (People with spinal stenosis, sciatica, or previous back surgeries were not included.) The participants were divided into four groups according to the type of treatment they would receive:
1) Individualized Acupuncture – At the beginning of each treatment session, the acupuncturist would evaluate the patient's current condition and determine which points to needle.
2) Standardized Acupuncture – The same points were needled for all patients in this group according to a predetermined prescription considered by experts to be effective for low back pain.
3) Simulated Acupuncture – Using the same points as were used for the standardized acupuncture group, acupuncture was simulated by using a toothpick in an acupuncture needle guide tube. tapping and twisting the toothpick to simulate the feel of an acupuncture needle being inserted.
4) Usual Care – Participants in this group received the usual forms of treatment chosen by their physicians – primarily medications and physical therapy.
Those in the acupuncture or simulated acupuncture groups were given 10 treatments over a seven-week period by experienced acupuncturists. Outcomes were evaluated after eight, 26, and 52 weeks.
After eight weeks (one week after the last treatment), the back-related dysfunction scores improved by 4.4 points for the individualized acupuncture group, 4.5 points for the standardized acupuncture group and 4.4 points for the simulated acupuncture group, compared to only 2.1 points for the usual care group. The groups receiving some form of acupuncture continued to have greater improvement than the usual care group all the way through to the one-year point as well.
The researchers concluded that:
- Acupuncture is more effective than usual medical care alone for chronic low back pain.
- Individualized and standardized acupuncture are equally effective for chronic low back pain.
- Simulated acupuncture is as effective as real acupuncture for chronic low back pain.
The researchers offered two possible explanations of why the simulated acupuncture was as effective as the real acupuncture:
1) Even superficial stimulation of acupuncture points stimulates physiological processes that lead to improved pain and function.
2) Nonspecific effects such as therapist conviction or patient expectation could contribute to a placebo-like effect.
Since I receive acupuncture treatments for my various fibromyalgia symptoms, I gave my acupuncturist a copy of this study and asked for his opinion. He agrees with the researcher's first explanation, as do I.
According to Chinese medicine, there are energetic pathways, or channels, throughout the body that influence associated internal organs and structures. Energy from these pathways surfaces at various points on the body, identified as acupuncture points. Each of these acupuncture points serves as a tunnel, or access route, to the deeper circulatory channels within. Acupuncture stimulates a selection of specific points, thereby activating the body’s natural healing abilities. Even the simulated acupuncture, as it was done for this study, provided significant stiumlation of the acupuncture points, which would in turn activate the energy flow from those points.
Admittedly I have a slight bias in favor of acupuncture because I have had such positive results for a number of different health issues. If you're considering acupuncture as a treatment for low back pain, I would like to caution you about your expectations. Acupuncture is not like a pain pill that you take and expect to have some relief in a few minutes – although I have known of some cases where headaches were relieved while the person was still on the table. Acupuncture helps your body to work more effectively to heal itself, which generally takes some time.
When people tell me they've tried acupuncture and it didn't work, I often find they've only gone to one or two sessions, then quit. Depending on the problem and what kind of shape you're in, it may take several sessions before you begin to see noticeable improvement. I'm not saying acupuncture is a cureall for everyone; I'm just saying don't waste your time and money unless you're willing to make a commitment to give it a fair chance.
If you'd like to read more about acupuncture and how it works to treat pain, read: Treating Pain With Acupuncture
Cherkin, PhD, Daniel C., et al (2009).A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain. Archives of Internal Medicine. 169 (9), 858-866.
Personal Interview with Acupuncturist Richard W. Morgan, LAc, LMT, CNT. May 19, 2009.
© Karen Lee Richards, 2009
Last updated: 5/31/09
Published On: May 31, 2009