Sept. 24, 2007 -- Acupuncture proved to be more effective than conventionallower back pain treatments in a new study, but it was no more effective than asham needle procedure.
The German study compared outcomes among 1,162 patients with chronic lowback pain treated with traditional Chinese acupuncture; sham acupuncture; or aconventional approach to treating back pain using drugs, physical therapy, andexercise.
The study is the largest investigation of acupuncture vs. conventionalnonsurgical treatment for lower back pain ever reported, researchers say.
"Acupuncture represents a highly promising and effective treatmentoption for chronic back pain," researcher Heinz Endres, MD, tells WebMD."Patients experienced not only reduced pain intensity, but also reportedimprovements in the disability that often results from back pain -- andtherefore in their quality of life."
Acupuncture for Back Pain
Endres says up to 85% of people will suffer from low back pain at some pointin their lives. The pain may last for a few days or continue as chronic lowback pain for months and years.
While a recent review of research showed acupuncture to be useful for thetreatment of low back pain when given in addition to other therapies, thelatest study was designed to determine if acupuncture is an effective treatmenton its own.
Acupuncture was delivered in 10, 30-minute sessions conducted over sixweeks. Patients who received conventional treatments had a similar number oftotal treatments, which included exercise, pain medication, and nonsteroidalanti-inflammatory drugs (NSAIDs).
The acupuncture groups were allowed to use medication for acute episodes ofback pain only. This consisted of NSAID use no more than two days a week duringthe treatment period.
Traditional acupuncture involved inserting needles at fixed points anddepths on the body and manipulating the needles in accordance with ancientChinese practice.
With the sham treatment, needles were inserted in the lower back atshallower depths at non-acupuncture points and the needles were notmanipulated.
Patients who got the traditional and sham acupuncture treatments were almosttwice as likely to report treatment-related responses six months later aspatients who did not have acupuncture.
Responses were defined as a 33% improvement in pain or a 12% improvement infunctional ability.
"Because acupuncture has a low risk of side effects and fewcontraindications, it should be added to the catalogue of treatmentsrecommended for acute and chronic back pain, even though -- just as for anyother form of treatment -- there will always be some patients who do notrespond," Endres says.
Sham Acupuncture Works
Several earlier studies involving patients with chronic pain have shownsimilar benefits for traditional and sham acupuncture.
A 2005 analysis of 33 back pain studies did show a treatment advantage fortraditional acupuncture, but a researcher involved in the analysis says morerecent studies challenge this finding.
"The evidence as a whole suggests that the benefits of true acupunctureover sham acupuncture are almost clinically irrelevant," Eric Manheimer,MS, of the University of Maryland Center for Integrative Medicine tells WebMD."The reasons for this are not really clear. It may be that putting theneedles anywhere stimulates some sort of analgesic effect."
Acupuncture is still considered an alternative treatment for low back painin the U.S., but this is no longer the case in Germany. Based on findings fromthe newly reported study, it is now covered by state health insurance.
Endres says acupuncture is a clearly useful treatment for low back pain,even if we don't understand why.
"Just because we cannot explain exactly the mechanism by which atreatment works, doesn't mean that it doesn't work," he says.
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