Acupuncture is a traditional Chinese medicine technique that involves pricking the skin with very thin needles at specific points on the body.
What does it have to do with low back pain? Read on!
What Is Acupuncture For Low Back Pain?
Acupuncture is a complementary medicine technique that is often used to treat a variety of conditions, including low back pain. While the treatment originated in ancient China, it has been growing in popularity in the western hemisphere.
The use of acupuncture for treating low back pain, however, is a slightly controversial topic and one that is a topic of ongoing debate and research.
Exactly How Does Acupuncture Work?
Acupuncture involves the insertion of very thin needles through your skin at strategic points on your body, called “acupoints”. These needles are designed to rebalance the energy that our bodies produce, also known as “qi”.
When the needles are inserted into the body, the idea is that natural chemicals are released and that this helps fight the illness or symptoms.
How Does Acupuncture Work For Low Back Pain?
When it comes to treating low back pain, acupuncture stimulates specific acupoints which, in turn, stimulate parts of the nervous system and tells it to feel less pain. Chemicals, known as endorphins, are released.
These endorphins are our bodies' natural painkillers that help to relieve pain. Endorphins also increase blood flow to the sore muscles, reducing inflammation and helping to speed up the healing process.
Acupuncture And Nerve Stimulation
Another way in which acupuncture may help to reduce low back pain is through the stimulation of nerve pathways. Research has shown that targeting acupuncture points can stimulate the central nervous system.
When they acupuncture points stimulate the nervous system, it releases chemicals into the muscles, brain, and spinal cord. These chemicals are believed to stimulate the body's natural healing abilities, stimulating the nerve pathways and restoring blood flow to the muscles.
If there has been any type of nerve damage that could be the cause of the low back pain then the research shows that acupuncture could be a useful tool to re-stimulate those nerves.
Acupuncture As Add On Therapy
There is growing evidence to support the use of acupuncture in combination with other treatments. One study found that when acupuncture was combined with exercise it was more effective at reducing low back pain than exercise alone.
Another study looked at the combination of acupuncture with traditional Chinese herbal medicine and found that it was more effective at reducing low back pain than either treatment alone.
Is Acupuncture Really Effective At Treating Low Back Pain?
While there are studies that suggest that acupuncture may be effective for low back pain, there is also research that suggests that it is not always effective.
A study published in JAMA as recently as 2021, found that in their study ‘there was no statistically significant effect of suggestions about treatment benefits or adverse side effects on patients’ treatment expectations or experience of adverse side effects’.
Another study was published in the British Medical Journal (BMJ) in 2018. This study reported that the researchers ‘did not find any statistically significant reduction in time-to-recovery after a single session of acupuncture for ALBP compared with standard care.’
Why The Confusion Around Acupuncture?
1. It can be hard to know whether acupuncture is a good idea for low back pain or not. For one, more studies need to be done and with more patients.
2. Another consideration is the complicated nature of the condition. It can be hard to find the cause of low back pain, and if we don’t know the cause it can be hard to know where to focus the acupuncture treatment.
3. Each person’s back pain is different. The severity is different. The causes are different. The duration is different. These differences make it hard to compare results and to see just how effective acupuncture can be.
4. Acupuncture is considered to be a complementary or alternative medicine so it’s still growing in acceptance as a mainstream treatment for low back pain. As more evidence comes in we should be able to know just how effective it really is for managing chronic low back pain.
What Do The Guidelines Recommend?
In 2016 the National Institute for Health and Care Excellence (NICE) recommended against the use of acupuncture for the management of non-specific low back pain.
Their guidelines recommend exercise, stretching, yoga, or aerobic exercise as a first step in managing low back pain and called acupuncture a “sham”. They did suggest that acupuncture and massage could be used alongside exercise but there isn’t enough benefit when used alone.
The Centers for Medicare and Medicaid Services (CMS) do approve the use of acupuncture for low back pain and will pay for up to 12 visits in 90 days.
Things To Consider Before You Try Acupuncture
Acupuncture is generally a very safe procedure but you should make sure that you work with a certified acupuncturist. You might want to ask your healthcare provider for a referral or do some research before your appointment.
While there are very few side effects some people have reported feelings of soreness, bruising, and minor bleeding at the needle insertion points. Most of the time these issues clear up in a few days and aren’t much to be concerned about.
If you are pregnant, take blood thinners, or have a bleeding disorder acupuncture may not be the right choice of treatment for you. You should definitely have a conversation with your healthcare provider before you make your decision.
Conclusions
Clinical studies have indicated that sham acupuncture can work just as well as real acupuncture for back pain. Something to remember, though, is that in many of the studies, researchers found that both sham acupuncture and real acupuncture worked better than no treatment at all.
When considering treatment for chronic low back pain it is important to take each person’s case individually and personalize their treatment plan.
International guidelines recommend the use of physical therapy, exercise, biofeedback, and cognitive behavioral therapy as first line treatments for chronic low back pain. Some guidelines do allow for treatments like spinal manipulation, and acupuncture as add on therapy.
If you are thinking about trying acupuncture for low back pain it is important to speak with your healthcare provider first and to make sure that you work with a licensed acupuncturist for your treatment.