A Focus on Lower Back Pain Research
Lower back pain: Acupuncture. The two could be married.
A lot of my patients come in for lower back pain, or have had acupuncture previously for their back.
Because it is such a commonly treated condition by acupucturists, there has been plenty of research conducted on the benefits of using acupuncture for lower back pain.
...Get prepared for some big words!
80-90% of adults experience lower back pain
at some point in their life. (1)
Lower back pain (LBP) creates a heavy burden on the ACC system, particularly when the condition becomes chronic. Management of LBP depends on the cause of the condition; treatments vary from pain medications to regular physiotherapist or chiropractor treatments or as far as surgery.
There are already many treatment options for LBP,
why use acupuncture?
Acupuncture is often the final treatment choice for lower back pain sufferers; however research shows that acupuncture can be highly beneficial in the management of pain.
Two recent and large randomized control trials (RTC’s) conducted in Germany and Seattle have compared conventional care to acupuncture for chronic lower back pain. The trials had 1162 and 638 participants respectively - which is relatively large sample size given acupuncture trials receive very little funding.
Participants of the usual care groups in these studies received a range of treatments including; medications, sessions with their physician, or physiotherapist (2, 3).
In both trials, acupuncture was almost twice as effective as conventional care (2, 3).
Adverse events/reactions during acupuncture were also rare with just 1/315 in the Seattle study (2) and is therefore considered a safe treatment (4). These trials confirm there is an important role that could be filled by acupuncture in the management of chronic lower back pain.
Can acupuncture be combined with other treatment therapies?
Acupuncture is commonly combined with tuina (traditional Chinese massage) as well as herbal and movement therapies.
It can also be used safely with better results in conjunction with pain relief medications such as Baclofen, as shown in a 2010 RCT. Although the trial was small with eighty-four participants, all who were men, the combined baclofen and acupuncture treatment was more effective than acupuncture or baclofen alone (5).
As pain medications are effective for immediate pain relief but do not treat the underlying cause of the pain, acupuncture could be an effective adjunctive treatment for the improvement of physiological functioning of the tissue structures of the lower back.
How does acupuncture work from a Western Medical paradigm?
A 2015 fMRI study conducted on experimentally induced acute lower back pain suggests that acupuncture analgesia may affect sensory, cognitive, and autonomic functions.
This may be due to the apparent deactivations in the limbic system and activation in the somatosensory system (6).
It has also been theorized that acupuncture has a physiological effect on connective tissue. It is proposed that manipulation of the acupuncture needle produces changes in fibroblast cells of the connective tissue, vital to the production of collegen and wound healing (7). Although these changes may occur no matter where the needle is placed, it appears the action is enhanced at acupuncture points.
Although these new findings do not change the Traditional Chinese Medicine (TCM) treatment approach in clinical practice, they may explain acupuncture mechanisms in a Western Medical paradigm. There is much to be studied and discovered in this field, with the aim to foster understanding and alliance between both paradigms.
So if you've got lower back pain, come on in for treatment - there's research to support that it'll work!
Book online here.
1. ACC. (2004). New Zealand Acute Low Back Pain Guide. New Zealand Guidelines Group. Wellington, NZ.
2. Cherkin DC et al. (2009). A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Available from: http://archinte.ama-assn.org/cgi/reprint/169/9/858.pdf
3. Haake M, et al. (2007). German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Available from: http://archinte.jamanetwork.com/article.aspx?articleid=413107
4. MacPherson H et al. (2001). A prospective survey of adverse events and treatment reactions following 34,000 consultations with professional acupuncturists. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11829165
5. Zaringhalam J et al. (2010). Reduction of chronic non-specific low back pain: a randomised controlled clinical trial on acupuncture and baclofen. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2867967/
6. Shi Y, et al. (2015). Brain Network Response to Acupuncture Stimuli in Experimental Acute Low Back Pain: An fMRI Study. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487721/
7. Langevin HM, Yandow JA. (2002). Relationship of acupuncture points and meridians to connective tissue planes. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12467083