Acupuncture best way to treat back pain, finds study

26 September, 2007

Acupuncture, the ancient Chinese practice of healing without medication, works better than anything modern medicine has devised for the treatment of back pain.

In trials conducted among 1,100 patients with chronic pain in the lower back – which had lasted for an average of 8 years – almost half (47%) of those who received acupuncture showed significant improvement, compared with barely a quarter (27%) of those given conventional treatment.

The effects lasted for at least six months, long after the treatment was completed.

The study was conducted by researchers from the University of Regensberg, in the spa town of Bad Abbach in Germany. The researchers randomly allocated patients to receive 10 sessions, lasting 30 minutes, of ‘sham’ acupuncture, real acupuncture or conventional treatment.

Sham acupuncture involved sticking needles in randomly over the lower back, avoiding the meridians and points that dictate where the needles are placed in traditional acupuncture.

The results showed that 44% of volunteers suffering from back pain showed a significant improvement with sham acupuncture.

Michael Haake, who led the study, published in Archives of Internal Medicine, said the superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation or transmission of pain signals and is stronger than the action mechanism of conventional therapy.

The findings add to evidence accumulated over the past 10 years suggesting that the 4,000-year-old, Chinese practice of acupuncture is an effective treatment for back pain, which affects up to 70%-85% of the population at some point.

The authors of the study concluded: “Acupuncture constitutes a strong alternative to multi-modal conventional therapy. It gives physicians a promising and effective treatment option for chronic low-back pain, with few adverse effects or contraindications.”

As for the equally good results with sham and acupuncture, the authors said, “The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals, or processing of pain signals by the central nervous system and that is stronger than the action mechanism of conventional therapy.”

Acupuncture, used to treat many medical conditions, has a controversial role in the management of low-back pain, though another study held earlier in Germany had concluded that it might be useful as an adjunct to other therapies.

The finding that both sham and true acupuncture relieved back pain is puzzling, remarked Dr Rex Marco, an orthopedic surgeon at the University of Texas Health Science Center in Houston, the United States. He speculated that the sham needling could have triggered endorphin release or other potentially therapeutic effects. The sham procedures also could have had an unexpectedly large placebo effect.

Alternatively, Dr Rex Marco said, the pain-relieving benefits of sham acupuncture might have been emotional or psychological in nature. “It is possible,” he explained, “that the physical contact during the sham procedures had a relaxing or soothing effect that helped relieve the pain. Maybe the contact and interaction with the acupuncturist was beneficial. It is really impossible to know why the sham procedures had a therapeutic effect. For that matter, it is entirely possible that the sham and true procedures worked through similar or the same underlying mechanisms.”

The findings by researchers at the University of Regensberg, Germany, are at odds with previous studies that have shown a difference between true and sham acupuncture, according to Eric Manheimer, a clinical research associate at the University of Maryland in Baltimore, the United States. More than one study has shown at least a trend in favor of true acupuncture, he added.