Acupuncture for low back pain
 

Many people with low back pain seek help from acupuncture. Acupuncture is one of the most widely researched complementary therapies – so much so that it is frequently available within the National Health Service.
There have been a number of research studies into acupuncture for back pain. What is their overall message? There have been previous efforts to combine the results, but they were inconclusive. Since several studies have recently become available, a group of researchers in the UK and the USA have undertaken a new review, funded by BackCare, which has been published in the Annals of Internal Medicine.
The authors searched as exhaustively as possible for all reports of controlled trials, writing to colleagues and acupuncturists throughout the world, and searching computerised reference lists.
Altogether, 33 studies covering a total of 2138 patients with low back pain were found for the review. Most of the studies investigated traditional acupuncture for chronic pain, and the results of these could be combined statistically. Of those that could not be combined, three concerned back pain in pregnancy (all three were positive“The authors searched as exhaustively as possible for all reports of controlled trials, writing to colleagues and acupuncturists leaves 22 studies for the main analysis.
Eight studies compared acupuncture with normal care: acupuncture was clearly (i.e. significantly) effective at reducing the pain, both in the short term and after 6 months. However, that could be due to the placebo effect: seven studies compared acupuncture with a ‘placebo’ treatment, in the form of either sham acupuncture or sham TENS. Acupuncture was significantly better at relieving pain in the short term.
A few studies compared acupuncture with massage, medication, manipulation, or TENS: there were no major differences here, with the exception that manipulation seemed to be superior in two studies of moderate scientific quality.
Some of the studies also measured changes in the patients’ function: acupuncture is clearly better at restoring normal function than normal care alone, though this difference is not still noticeable 6 months later.
The researchers concluded that acupuncture for patients with chronic low back pain provides definite short-term pain relief; this relief appears to be long-lasting, and is definitely not just a placebo effect. The pain relief is accompanied by an improvement in function. The areas of research that still remain include more comparisons (especially cost comparisons) with other treatments that are used for low back pain.