Acupuncture May Provide Benefit in Chronic Lower Back Pain |
Acupuncture May Provide Benefit in Chronic Lower Back PainAcupuncture, a treatment that goes back over 2000 years, is gaining popularity as an alternative treatment in the Western world, particularly for treatment of chronic lower back pain (CLBP). There are different styles of acupuncture available: Japanese Meridian Therapy, French Energetic acupuncture, Korean Constitutional acupuncture, and Lemington Five Elements acupuncture. Other forms have also been created. Use of acupuncture is based on the belief that the body is a balance of two opposing forces: yin and yang. When a person is sick or disabled, these become unbalanced, blocking the flow of vital energy in the body. Through applying needles to acupuncture points along certain pathways in the body, the balance is restored. How acupuncture works is not known, however researchers do have several theories. They range from the nervous system reacting to the needles and producing biochemical and endorphins that influence pain sensation to stimulation of vascular and immunomodulatory factors, such as mediators of inflammation. While acupuncture does not have any specific diagnostic testing to be performed before beginning treatment, there are some groups of patients who should not undergo acupuncture. They include those who have hemophilia, bleeding disorders, septicemia, cellulitis, skin infections, or loss of skin integrity from burns or ulcerations at the site where the needles will be inserted. If the acupuncturist uses electroacupuncture, this should not be performed over the brain or heart, nor in an area of an implanted electrical device. Pregnant women, those taking anticoagulants, and people with metal allergies should proceed with caution. The authors of this article reviewed several studies that investigated the efficacy of acupuncture compared with other forms of treatment, including sham treatments. The findings are as follows: - moderate evidence that acupuncture is more effective for short-term and immediate pain relief, and immediate functional improvement, than no treatment in treating CLBP (1 high-quality study, 2 low-quality studies) As with all treatments, some complications or side effects do occur, as reported in 12 trials. These side effects included local bleeding or hematoma, worsening of CLBP, tiredness, drowsiness, light-headedness, and dizziness. Serious complications, such as hepatitis, septicemia, and pneumothorax were rare. The authors conclude that there "appears to be some evidence for the use of acupuncture for the treatment of CLBP." They do caution, however, that more studies are needed to determine positive benefits of acupuncture beyond that of comparisons with placebo. Carlo Ammendolia, DC, PhD, et al. Evidence-informed management of chronic low back pain with needle acupuncture. In The Spine Journal. January/February 2008. Vol. 8. Issue 1. Pp. 160-172. |