While acupuncture is readily accepted as a viable option for low back pain in mainstream modern medicine, there has been little research to prove that it works.  Now there are studies that support the clinical evidence.

In a German study published in the Archives of Internal Medicine, 1,162 adults with chronic, lower back pain were divided into groups treated with the standard pharmaceutical and exercise therapy commonly used in Western medicine and acupuncture. The researchers reported that acupuncture provided relief and lasting benefit to nearly twice as many lower back pain patients as drugs and exercise. Forty-eight percent of the acupuncture patients reported at least a one-third decrease in pain along with improvement in their ability to function, versus 27 percent of the patients treated with conventional methods reporting such benefits.

In the July 2009 issue of Acupuncture Today, they reported findings from a new study.  Published in the May 2009 issue of Archives of Internal Medicine this new study adds to the growing body of evidence showing the efficacy of acupuncture for back pain.

In this study, 638 patients suffering from back pain were divided into four groups:

Individualized acupuncture: This treatment was prescribed by the diagnostician at the beginning of each visit. There were no constraints on number of needles, depth of insertion or needle manipulation. Needles were retained for 18 minutes. Seventy-four distinct points were used.

Standardized acupuncture: This protocol used a standardized acupuncture prescription considered effective for chronic low back pain, including DU3, UB23 on either side, low back Ashi point, UB 40 on either side and KD 3 on either side. All points were needled for 20 minutes, with needle stimulation at 10 minutes and again just prior to removal.

Simulated acupuncture*: This technique used a toothpick in a needle guide tube. All acupuncture points were stimulated with toothpicks at 10 minutes and again at 20 minutes, just before they were “removed.” The acupuncturists simulated insertion and removal of needles at the eight acupuncture points used in the standardized treatment.

Usual care: Participants in this group only received the care, if any, they and their physicians chose. This was mainly medications, and primary care, and physical therapy visits. All participants received a self-care book with information on managing flare-ups, exercises and lifestyle modifications.

At 8 weeks all patients showed improvement, however, the “usual care” group improved only 2.1 points improvement, scored on a disability questionnaire, as opposed to the individualized, standardized and simulated acupuncture groups who improved by 4.4, 4.5 and 4.4 points respectively.

The greater improvement for the acupuncture groups continued to 52 weeks, the end of the study.

Researchers concluded that compared to usual care, acupuncture had beneficial and persisting effects on chronic back pain.  They stated the acupuncture treatments resulted in clinically meaningful improvements in function, and really, isn’t that the bottom line when you’re getting treatment for pain?

*Simulated acupuncture.  Ironically, this simulated acupuncture is known by practitioners by another name – acupressure.  Additionally, many of the earliest acupuncture practitioners used needles-like implements to stimulate a point but did not insert the implement into the body, or if they did it was a very shallow pricking insertion.  Full insertion into the body came later, so it’s no surprise to any acupuncturist that “simulated” acupuncture would work as well as acupuncture with needle insertion.

Low back pain is an extremely common concern, affecting anywhere from 75 to 90 percent of people at some point in their lives.  Low back pain is second only the common cold as a cause of lost days at work and is one of the most common reasons to seek medical care, including acupuncture. In fact, one of the top reasons that people get acupuncture treatments is for low back pain.

The Oriental Medicine Perspective of Low Back Pain

In spite of the large number of pathological conditions that can give rise to low back pain, up to 85% of the cases are classified by Western physicians as ‘non-specific’. When low back pain is looked at from an Oriental medicine perspective, it is seen as a disruption of the Qi within the area and associated with a specific disharmony and then treated accordingly.

The basis of acupuncture is expressed in this famous Chinese saying: “Bu tong ze tong, tong ze bu tong” which means “free flow: no pain, no free flow: pain.”

In other words, any kind of pain or illness represents an obstruction in the normal flow of Qi or life force. Simply put acupuncture moves Qi restoring free flow.

The disruption of Qi that results in low back pain is usually associated with the following three disharmonies.  When reading these descriptions, please bear in mind the differences between Western anatomical organs and Oriental Medicine’s organ systems.  As distinct from the Western medical concept of internal organs, this concept from Traditional Oriental Medicine is more a way of describing a set of interrelated parts than an anatomical organ. To differentiate between western or eastern concepts of organs the first letter is capitalized, therefore, in the description of weak Kidney Qi we are in no way associating this with disease of the kidney.  If you have questions on this, please drop me an email or send me a text and I will explain further.

Weak Kidney Qi – In Oriental medicine, the lower back is referred to as the “dwelling of the Kidneys. The majority of chronic low back pain conditions are associated with Kidney Qi Deficiency. This type of pain is dull and comes and goes. It is usually aggravated by over tiredness and improves with rest.

Stagnation of Qi and Blood – When the flow of Qi along the meridians that traverse the lumbar region becomes congested, it is referred to as the stagnation of Qi and blood. This presents with a severe stabbing pain that is worse with rest and better with movement, tender to touch and can be accompanied by stiffness and tightness.

Invasion of Cold and Dampness – Cold, damp type pain is worse in the morning and when the weather is cold and damp. This type of pain Improves with movement and the application of heat.  Stiffness and contraction of back muscles that is aggravated by rest indicates cold predominance while swelling, numbness and a heavy sensation are indicative of dampness.

Next time – Studies on Acupuncture and Low Back Pain