Acupuncture Relieves Chronic Low Back Pain
Acupuncture relieves chronic low back pain more effectively and in a more lasting way than conventional orthopedic treatments, according to a recent study published in Pain (2002;99:579–87).
Back pain is one of the most common conditions plaguing people in Western societies, affecting more than 31 million people in the United States, with costs in healthcare and lost productivity exceeding $50 billion annually. Conventional therapies include bed rest; stretching and physical exercise; muscle relaxing modalities such as hot packs, ultrasound and infrared; and anti-inflammatory and analgesic (pain relieving) medications. Unfortunately, these therapies are frequently ineffective. Furthermore, long-term use of anti-inflammatory drugs can lead to gastritis and ulcers, and excessive use of some analgesics can damage the liver.
The current study evaluated the effect of including acupuncture in the treatment of chronic low back pain. All of the 174 participants in the current study received conventional treatment, consisting of physiotherapy (massage and electrical therapies), physical exercise, classes on back care, mud packs, and infrared heat therapy. They were randomly assigned to one of three groups: (1) concurrent acupuncture, (2) concurrent "sham" acupuncture (needles placed randomly instead of in true acupuncture points), or (3) conventional therapy alone.
Each participant received 12 treatment sessions over the four-week trial. At the end of the trial, only 43% of those receiving conventional therapy alone reported at least 50% pain reduction, while 65% of those receiving concurrent acupuncture experienced this much pain relief. At a follow-up three months after the end of the trial, the proportion of people in the conventional therapy group who maintained at least 50% reduction in pain dropped to 14%, while in the acupuncture group the number rose to 77%. Among those receiving concurrent sham acupuncture, 34% reported at least a 50% reduction in pain at the end of the trial and 29% maintained this much relief at three months.
The results of this study demonstrate the lack of lasting benefit from conventional therapies, and the immediate and lasting effect of acupuncture for chronic low back pain. Acupuncture significantly improved the immediate effectiveness of conventional treatment, and its benefits persisted for at least three months. Sham acupuncture appeared not to add to the immediate effectiveness of conventional therapy but, for those who benefited, pain relief was significantly more lasting than for those receiving no needling. Needling at any point has been shown to raise levels of endorphins (chemicals that relieve pain), and the authors point out that this may explain the benefit of sham acupuncture.
Acupuncture has been used for over 2,000 years for a wide variety of conditions with minimal side effects. This study adds to a large body of evidence that acupuncture is an effective treatment for back pain, although a few studies have produced negative results. Researchers wanting to evaluate acupuncture are faced with a number of challenges, including different needling styles and difficulty establishing a placebo (inactive) treatment for comparison. Sham acupuncture was used as the placebo in this and in many other studies, but biological responses to sham acupuncture have clearly been demonstrated, leading to confusing outcomes and conclusions. The effect of sham acupuncture on long-term pain relief in this study continues to support the existence of biological responses to needling in general. More studies of these responses will add to our understanding and will help researchers to develop better clinical trials in the future.
Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, Vermont, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.
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