Acupuncture for back pain - useful alternative pain relief

Acupuncture for back pain is a very old tradition that involves the  ancient practice of introducing needles into specific points in the body. The practice dates back thousands of years to China when they used to use needles made of bamboo. Certain groups of points seemed to be beneficial for treating certain types of diseases and over the years this knowledge grew into a map of specific acupuncture points. The lines along which these points lie are called meridians. There are 14 main meridians identified and approximately 700 points.

Over time, as our understanding of the science of pain has increased, the way in which acupuncture works has been more accepted into modern medical thinking. There are therefore two main schools of thought about acupuncture.

Traditional Chinese Medicine (TCM)

Acupuncture points model showing the lines of the meridians Image Courtesy Joe Mabel via Wikimedia Commons

The TCM approach believes that the body is infused with a life force or energy called Ch’i which flows around the body. An obstruction in this energy leads to deficiencies and illness and a traditional Chinese acupuncturist would aim to locate where any excesses and deficiencies lie.

Treatment of appropriate acupuncture points would then be used to try and restore the flow of energy into the system.

The Western Approach

The western approach to acupuncture believes that inserting needles causes physiological changes in the body which alters our pain response. There are several theories on what changes exactly take place but it is clear that the bodies own pain reliving chemical, endorphins, are released during acupuncture. This approach to acupuncture does not require the needles to be placed in any specific points.

Acupuncture for back pain

There has been conflicting evidence about whether acupuncture for back pain is effective or not. Research published in 2006 (1) suggested small improvements using acupuncture for back pain over usual care. However, a newer study (2) has recently been published looking at the effectiveness of acupuncture for back pain. This study took a large sample of 1162 patients and split them into three groups. One group had usual medical care, the second group had traditional acupuncture and the third group had acupuncture where the needles were placed at random and not in acupuncture points. Interestingly both the acupuncture groups did better that the usual treatment group but there was really no difference between the more traditional type of acupuncture and the more western style.

RESEARCH UPDATE 2010 :Recent guidelines published in the UK recommend acupuncture for back pain treatment if you have had pain for more than 6 weeks but less than a year (3)

I have written more about this particular trial for acupuncture and back pain

So…is acupuncture for low back pain good alternative pain relief?

It looks like the answer is yes, but we are not really sure why, is it because of a placebo effect or is it caused by changes in the pain response? I'm not sure but I don't really mind either way. In truth anything that is helpful in managing chronic lower back pain is a good thing provided it does not encourage passive dependence on treatments and as long as it is not used in place of other ongoing self management such as exercise and advice.

References

1. K J Thomas,et al Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ, Sep 2006; 333: 623 ; doi:10.1136/bmj.38878.907361.7C

2. Michael Haake, et al German Acupuncture Trials (GERAC) for Chronic Low Back Pain Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups Arch Intern Med. 2007;167:1892-1898.

3.NICE Low back pain.

Return to Back Pain Relief for an overview of other treatments for lower back pain.

From acupuncture for back pain to Lower Back Pain Toolkit Home Page

20-Dec-2010