Acupuncture and Low Back Pain
Larry (not his real name) hobbled into my office one day, unable to stand up straight. He was a veteran who had numerous injuries and surgeries to his low back. This caused him many years of back pain and sciatica that kept him from being able to work. He couldn’t walk or stand for more than 10 minutes without squatting to relieve the pain. Most of his life revolved around managing it, including stretches, hot tubs and periodic injections. Even surgery didn’t make a dent in his pain.
For his first appointment, Larry had a hard time lying face down on the table, so we had to lay him on his side to treat him. He got some short-term relief from the first treatment – enough to continue to show up. After a few months of massage, cupping, and electro-acupuncture he was able to lay face down on the table during treatments. He started doing more work around the house, taking care of his property, tending to his garden and chickens. Eventually he was pain free enough to go back to hold down a job.
Larry’s case was pretty extreme, to the point where nothing is going to fix his back permanently. But we’re able to keep him moving and pretty pain free without taking pain meds. In many other cases, I’ve seen back pain resolve completely without needing ongoing care.
Since low back pain is so common, and can be so debilitating, there’s been plenty of research on using acupuncture to treat it. I’ve rounded up just a few studies to show you how effective it can be. Don’t take it from me, read on to see what science has to say about treating low back pain with acupuncture.
A Randomized Controlled Trial
This study included 298 patients with a clinical diagnosis of chronic back pain for at least 6 months. They were divided into 3 groups: acupuncture, minimal acupuncture or waiting list. The minimal acupuncture group received a few shallowly inserted needles on the body in places other than the back. This intervention was chosen to be a type of placebo, and participants didn’t know whether they were receiving “real” acupuncture or “minimal” acupuncture.
Both of the treatment groups received 12 acupuncture treatments over 8 weeks. They were given pain questionnaires to track pain intensity, functional movement of the back, emotional stability and health related quality of life. They took these tests before the trial began, at the end of 8 weeks, then again after 26 weeks and 52 weeks.
The study showed the group who received acupuncture had a decrease in pain intensity from baseline to week 8, and that 8 of the 10 factors that were measured (including quality of life) also significantly improved. After 26 and 52 weeks the acupuncture group tended to have done better in all outcomes measured than the minimal acupuncture group.
Click the link above to see the actual study.
A Systematic Review
In this paper, researchers took a look at 7 different randomized controlled trials which included 13,874 participants all together. Each study evaluated acupuncture against a control group. The control groups included minimal or sham acupuncture, conventional treatment (including physical therapy and medication), placebo TENS, or no treatment at all. They all used questionnaires aimed at measuring pain intensity levels, functional ability, and quality of life.
Through their analysis, the researchers found “some evidence to support acupuncture is better than no treatment, and some forms of conventional therapy, in providing some pain relief. The evidence from the review supports the theory that there is no significant difference between acupuncture and sham acupuncture”.
A quick note about “sham acupuncture”. In a typical double-blind placebo study, a placebo is used to test how well the intervention performs compared to a pretend treatment. Researching medications is easy to do in this way – the placebo group just receives a sugar pill that looks exactly like the medication. It is much more difficult to create pretend acupuncture. The same could be said about massage. How do you get a pretend massage?
Sham acupuncture is conducted in different ways, depending on the study. Some people receive acupuncture, but the points selected don’t correspond to the thing they’re being treated for. Or they may put pins in places that aren’t actually acupuncture points. A fake acupuncture needle has been created, which doesn’t break the skin, but instead just rests on the skin. And I’ve even seen a study where toothpicks were used.
If you read about a study where acupuncture didn’t perform any better than sham treatment, dig deeper. If the study also included a control group which didn’t receive any treatment, you will probably find that both the acupuncture and the sham groups performed better than the control. This just shows that even acupressure, and poorly performed acupuncture, still work almost as well as skilled acupuncture.
Acupuncture Vs. Back Surgery
Since many of my patients (and maybe you too) are coming to acupuncture to try to avoid surgery, this study caught my eye. It’s actually a retroactive cohort study, which means that the researchers looked back at a whole population of patient records to find patterns in treatment.
An entire health database was searched for patients that had been newly diagnosed with low back pain, over a 10-year period. They found 138,207 patients who received acupuncture for their back pain, and 143,632 that did not. They followed these patients for 2 years and found statistically significant results that showed patients who received at least 2 acupuncture treatments were less likely to get back surgery.
Ready to give acupuncture a try? If you’re in the Greenville area, I’d love to help!
Author:
Elizabeth Williams, LAc is an acupuncturist and herbalist in Greenville, South Carolina, specializing in pain management, women’s health, and psycho-emotional issues. She’s passionate about helping people feel their best and sharing her wealth of knowledge with the community. Elizabeth is the owner of Dragonfly Acupuncture & Massage on Wade Hampton Boulevard. Appointments can be made by calling 864-451-4313 or scheduled online.