Acupuncture Eases Lower Back Pain

Sept. 14, 2006 -- Acupuncture can provide long-lasting benefits to low back pain sufferers, and is a cost effective treatment, according to new research from the U.K.

Patients treated with 10 sessions of acupuncture over three months reported less pain at a 24-month follow-up than patients who did not get the therapy.

Study co-author Hugh MacPherson, PhD...tells WebMD that the ancient Chinese medical treatment has proven its worth as an adjunct to traditional therapies for nonspecific back pain.

"Acupuncture definitely has a role in the treatment of low back pain," he says. "And it seems to be associated with longer-term effects than anyone has realized."

Back Pain Hard to Treat

Chronic back pain is one the most common and difficult-to-treat medical problems in health care.

The costs in terms of lost productivity and workers' compensation are staggering.

Acupuncture has become an accepted treatment for the condition in both the United States and in Europe. But clinical evidence of its effectiveness has been equivocal.

In an analysis of 33 studies, published in 2005, acupuncture was found to be an effective short-term treatment for low back pain, even when compared with sham treatments using fake acupuncture, says Eric Manheimer, MS, of the Center for Integrative Medicine at the University of Maryland.

"Our analysis suggested that the benefits of acupuncture for low back pain are not due to a placebo effect," Manheimer tells WebMD.

But a large study published in February of this year showed otherwise.

Low back pain patients treated with acupuncture reported better pain control than those who got no acupuncture.

The study included 241 adults who had had nonspecific low back painback pain for four to 52 weeks.

Patients were randomly assigned to receive either standard care or acupuncture, along with individualized treatment administered by a general practitioner. Standard care included medications, back exercises, and physiotherapy.

At three months, patients in the acupuncture group were much more likely to report being "very satisfied" with their treatment than those who did not get the therapy.

And at 24 months, the acupuncture group was more likely to report less worry about their back pain and less use of pain drugs.

They were also more likely to report having no pain for at least a year, leading the authors to conclude acupuncture provided long-lasting benefits.

"This was one of the most unexpected findings," MacPherson says.

In a separate analysis, acupuncture was also found to be cost effective compared with the usual treatment without acupuncture.

Evidence is mounting that acupuncture can help people with low back pain, but few studies have compared the treatment to other nonconventional therapies.

 

Massage Eases Lower Back Pain, Increases Range of Motion

Adults with chronic low-back pain found relief from massage therapy, according to a research study. Massage eased pain, reduced depression and anxiety, and improved sleep and range of motion.

The study, "Lower Back Pain is Reduced and Range of Motion Increased After Massage Therapy," was completed in January 2000 by the Touch Research Institute in conjunction with the University of Miami School of Medicine and Iris Burman of Educating Hands, and was first published in the International Journal of Neuroscience.

Twenty-four adults who had experienced low-back pain for at least six months were randomly assigned to either a massage therapy group or a relaxation therapy group.

The massage therapy group received twice-weekly, 30-minute massages for five weeks. Starting in the prone position, the following techniques were used: kneading and pressing the back muscles, stroking both sides of the spine and hips, gliding strokes to the legs, and kneading and pressing the thighs. Continuing in the supine position, participants received: gliding strokes to the neck and abdomen, kneading of the rectus and oblique muscles that help bend the trunk of the body forward, stroking of the legs, kneading of the anterior thighs, flexing of the thighs and knees, and gentle pulling on both legs.

Assessments taken before and after the first and last sessions included: the Profile of Mood States Depression Scale to rate depression; the State Anxiety Inventory to rate feelings at the present moment; the McGill Pain Questionnaire to measure pain; the Visual Analogue Scale to measure present level of pain; the Range of Motion Measures test to rate the level of ability to bend; a Symptom Checklist-90 Revised to measure moods; a sleep scale to measure quality of sleep; and urine samples to measure levels of the stress hormone cortisol, serotonin and catecholamines (amino acid derivatives that affect the nervous system, cardiovascular system, metabolic rate, temperature and muscles).

Results showed that both groups experienced a decrease in stress and long-term pain, but only the massage group experienced less pain directly after the session, fewer depressive symptoms, better sleep, improved range of motion and an increase in serotonin and the catecholamine dopamine biochemical levels.

"The findings from the present study are compelling and if the effects can be replicated and persist, these data suggest that massage therapy effectively reduces pain, positively impacts on the biochemical system, and attenuates psychological symptoms associated with lower back pain," the study authors wrote.

The authors also wrote that future studies might "examine the impact of massage therapy on job productivity and absenteeism for individuals with chronic low back problems."

- Source: Touch Research Institute. Originally reported in International Journal of Neuroscience, 2001, Vol. 106, pp. 131-145.