Acupuncture and Back Pain - NIH Research

By Bill Reddy, L.Ac., Dipl.Ac.

Most nurses, when asked about acupuncture as a non-surgical option for back pain, do not feel confident to respond with a reasonable "evidence-based" answer. This article will de-mystify acupuncture and herbology, referred to in China as "Traditional Chinese Medicine" and outline the strengths and weaknesses of this age-old healing art.

According to the National Institutes of Health, back pain is the second most common reason Americans go to see a Physician, and one of the more common reasons for surgery. Statistics show that 60 to 80 percent of the population will be disabled - some more severely than others - by back pain at some point in their lives. Estimates of up to 175 million work days are lost due to back injuries or pain, costing the US economy $50 Billion annually.1 The sad thing is that 17 percent of people who have undergone a surgical procedure on their back will have additional surgeries.2 How many patients do you know who have had back surgeries and, after the operation, have never been "quite the same?" Wouldn't it be great to have a noninvasive approach to low back conditions?

The good news is that Acupuncture and Oriental Medicine are quickly becoming popular in the western world as an alternative to drugs and surgery. According to the World Health Organization consensus statement, low back pain is listed as one of sixteen neurological and musculoskeletal disorders that acupuncture is effective in treating.3 It works effectively on chronic as well as acute low back pain. A commonly asked question is, "How does inserting extremely thin stainless steel needles into very specific locations on a patient make their back pain go away?" Allopathic medicine is still learning the mechanisms of acupuncture. What they've found, according to an article in the Journal of Acupuncture Electrotherapeutics Research in 1987 is that acupuncture reduces local Substance P (a neurotransmitter that sends pain to your brain) and L-Tryptophan, while increasing local levels of Serotonin.4 Acupuncture is also known to release endorphins, that make the patient feel good in the process of accelerating healing in the injured area. Substance P is a critical element in chronic pain. When a person sustains an injury or trauma to a body part (let's say the elbow), their natural instinct is to protect it. Substance P may be the body's defensive mechanism to keep people from re-injuring that area, long after it has completely healed. Acupuncture is the key element involved in breaking that cycle of events and eliminating the collection of substance P along the nerve pathway.

Pain caused by muscle spasm, local inflammation, osteoarthritis, muscular or tendonous injury, and sciatica are all good candidates for acupuncture therapy. Structural problems such as severely herniated discs, spinal stenosis, and late stages of degenerative disc disease respond poorly to acupuncture. Herbal medicine, unlike NSAIDS, goes to the root of the pain, "balancing" the body and after a certain length of time, is no longer needed. Acupuncture and herbs work in a synergistic fashion.

A recent article in the Annals of Internal Medicine (2005), University of Maryland Center for Integrative Medicine researchers summarized a meta-analysis of acupuncture on relieving chronic back pain. They began by searching a number of medical databases, including NIH, Cochrane Central, and EMBASE for randomized controlled trials of acupuncture, and found 33 that fit their parameters. The conclusion of this study was that "Acupuncture effectively relieves chronic low back pain."5 Not only does Traditional Chinese Medicine withstand the test of time, it also withstands the scrutiny of double-blind, placebo controlled studies. To assist your patient in finding a nationally board-certified, licensed acupuncturist, go to http://www.nccaom.org or http://www.acusova.com specifically for those who practice in Virginia.

  1. Oakley, J., Racz, G., Gallagher, R., "Back and Neck Pain Overview", The National Pain Foundation website (http://www.spineuniverse.com/displayarticle.php/article2619.html), 2005 Feb 10.
  2. Dvorak, et al, Spine 13(12): 1418-22, December 1988
  3. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, (ISBN 92 4 154543 7), WHO Geneva, 2002
  4. Omura, Y., Basic electrical parameters for safe and effective electro-therapeutics [electro-acupuncture, TES, TENMS (or TEMS), TENS and electro-magnetic field stimulation with or without drug field] for pain, neuromuscular skeletal problems, and circulatory disturbances., Acupunct Electrother Res. 1987;12(3-4):201-25.
  5. Manheimer E, White A, Berman B, Forys K, Ernst E., "Meta-analysis: acupuncture for low back pain.," Ann Intern Med. 2005 Apr 19;142(8):651-63. Review.

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