Lower Back Pain May Respond Better To Acupuncture Therapy Than Conventional Therapy

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Main Category: Back Pain
Also Included In: Complementary Medicine / Alternative Medicine;  Rehabilitation / Physical Therapy;  Clinical Trials / Drug Trials
Article Date: 24 Sep 2007 - 13:00 PDT

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If you suffer from lower back pain you might find that six months of acupuncture gives you superior results to conventional therapy, says a report in Archives of Internal Medicine (JAMA/Archives), September 24th issue. However, the study also indicates that sham acupuncture seems to be effective as well.

The authors explain "Low back pain is a common, impairing and disabling condition, often long-term, with an estimated lifetime prevalence of 70 percent to 85 percent. It is the second most common pain for which physician treatment is sought and a major reason for absenteeism and disability."

Although acupuncture is becoming increasingly popular as an alternative therapy, to date its usefulness as a treatment for low back pain has been unclear, say the researchers.

Michael Haake, Ph.D., M.D., University of Regensburg, Bad Abbach, Germany, and team carried out a randomized clinical trial with 1,162 patients, their average age was 50. They had all had chronic low back pain for about eight years (average).

They were divided into three groups:

1. Verum acupuncture, two 30-minute sessions per week, ten sessions total - 387 patients
This consisted of needling fixed points and additional points to a depth of 5 millimeters to 40 millimeters based on traditional Chinese medicine

2. Sham acupuncture, two 30-minute sessions per week, ten sessions total - 387 patients
This consisted of inserting needles superficially - 1 to 3 millimeters into the lower back, but avoiding all the known verum points or meridians.

3. Conventional therapy, two 30-minute sessions per week, ten sessions total - 388 patients
This consisted of a combination of drugs, physical therapy and exercise.

For those who had a partial response to treatment - 10% to 50% pain reduction - five additional sessions were offered.

The authors wrote "A total of 13,475 treatment sessions were conducted (verum acupuncture, 4,821; sham acupuncture, 4,590; conventional therapy, 4,064),"

59.9% (232) of those in the verum group received five additional sessions, as well as 54% (209) in the sham group and 52.5% (192) in the conventional group.

The researchers defined a Response Rate as a 33% pain improvement and a 12% functional ability improvement.

The authors noted "At six months, response rate was 47.6 percent in the verum acupuncture group, 44.2 percent in the sham acupuncture group and 27.4 percent in the conventional therapy group. Differences among groups were as follows: verum vs. sham, 3.4 percent; verum vs. conventional therapy, 20.2 percent; and sham vs. conventional therapy, 16.8 percent."

The researchers concluded "The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals or processing of pain signals by the central nervous system and that is stronger than the action mechanism of conventional therapy. Acupuncture gives physicians a promising and effective treatment option for chronic low back pain, with few adverse effects or contraindications. The improvements in all primary and secondary outcome measures were significant and lasted long after completion of treatment."

Archives of Internal Medicine
2007;167(17):1892-1898.

Written by: Christian Nordqvist
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