Low Back Pain

I have suffered from low back pain most of my life. I was diagnosed at age 18 with several healed compression fractures. My first experience with acupuncture was when I was in a car accident at age 22. It was the only thing that helped the pain (medication and physical therapy didn’t). To round off my litany of back pain, in my last year of medical school, I developed a fast-growing spinal cord tumor, a schwannoma, and by graduation, I couldn’t sleep and had trouble walking. And no, I am not going to say acupuncture solved that; major surgery did. Though regular acupuncture and herbs helped me recover.

I understand the unique nature of low back pain…a little too intimately.

The opioid epidemic has been in the news a lot lately. And low back pain in the most common form of chronic pain. This is not a good combination. Many studies are under way right now to determine if acupuncture is an appropriate alternative to opioids, especially in cases of chronic low back pain. While the results of these trials may be a few years away, there is plenty of evidence to show how effective acupuncture can be in treating low back pain.

This evidence shows efficacy in treating low back sprain/strain, lumbar facet syndrome, lumbar disc herniation, unspecified low back pain/myofascial pain, sciatic neuralgia, spondylolisthesis, low back pain in pregnancy, and sacroiliac sprain/strain among other conditions.

clinical practice guideline from the American College of Physicians and the American Pain Society states “For patients who do not improve with self-care options, clinicians should consider the addition of nonpharmacologic therapy with proven benefits-for acute low back pain” including acupuncture. The same societies in a systematic review, state “We found fair evidence that acupuncture… [is] also effective for chronic low back pain.

A relatively large (638 patients) 2009 randomized trial concludes “acupuncture was found effective for chronic low back pain.”

Cochrane review, often considered to be of high evidence, states “For chronic low-back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment” and “The data suggest that acupuncture and dry-needling may be useful adjuncts to other therapies for chronic low-back pain.”

While there are skeptics of the use of acupuncture in low back pain, they generally fall into two categories. One category of skeptics is against acupuncture in general and ignores and attacks any positive research. The other category disregards most studies because “sham” acupuncture shows similar results to verum or true acupuncture. As I have summarized in other articles (and will eventually write a specific article) “sham” acupuncture is usually not sham and is a form of true acupuncture. The bottom line is there is a ton of evidence supporting the use of acupuncture in low back pain.

Of special note: I use a technique particularly useful for herniated disks and I have seen lots of clinical efficacy using it. If you suffer from a herniated disk, and you are being told surgery is your only option, why not try acupuncture first?

Here is some additional research supporting the use of acupuncture in low back pain:
Acupuncture for back pain: a meta-analysis of randomized controlled trials.
Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up.
Acupuncture for chronic low back pain in older patients: a randomized, controlled trial.
Does acupuncture improve the orthopedic management of chronic low back pain–a randomized, blinded, controlled trial with 3 months follow up.
Efficacy of electroacupuncture and TENS in the rehabilitation of chronic low back pain patients.
The use of electro-acupuncture in conjunction with exercise for the treatment of chronic low-backpain.
Acupuncture relieves pelvic and low-back pain in late pregnancy.
Acupuncture for low back pain in pregnancy–a prospective, quasi-randomised, controlled study.

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