Learning about acupuncture for back pain is the first step in deciding if acupuncture is right for you. When you are not interested in surgery or other more conventional treatments for your pain, or when standard treatment methods have failed, acupuncture may be worth your consideration.
"control pain and promote good health"
Acupuncture for back pain is a form of traditional Chinese medicine that involves the stimulation of specific points on the body to control pain and promote good health. It is used to treat sciatica and many different causes of back pain including spinal stenosis, herniated disc, and degenerative disc disease.
In traditional Chinese medicine the human body is thought to be covered by several channels or meridians. It is through these channels that the body’s qi or "vital energy" flows. When the flow of this "vital energy" is obstructed or blocked, pain and ill health will result.
"stimulate specific points along the meridians"
There are many different forms of acupuncture, and many differences between practitioners. Some of the more common styles are Classical Chinese, Japanese, Tibetan, Vietnamese and Korean acupuncture.
An acupuncturist will use a variety of techniques to stimulate specific points along the meridians, and these points are not necessarily in the region of the pain. Acupuncture for back pain may involve the stimulation of other areas, such as the feet or ears. Needles, pressure, and heat, are often used to promote the flow of energy.
"If history is used to judge effectiveness..."
The needles used are disposable stainless steel and very thin measuring 0.18 mm to 0.51 mm in diameter. Some practitioners will electrify the needles with small amounts of electricity.
If history is used to judge effectiveness, acupuncture must be considered to be very effective. The earliest evidence of its use is stone needles found in China that are thought to be 5000 years old.
"scientific studies seem to yield contradicting results"
Modern efforts to understand this form of ancient medicine have largely been fruitless and confusing. Never the less, in some people, for some problems, it seems to be very effective.
Multiple scientific studies seem to yield contradicting results. One recent study, looking at acupuncture for back pain, reported in the Annals of Internal Medicine, seemed to show better relief of pain with acupuncture, and simulated acupuncture, than with standard treatments of a doctor’s visit, chiropractic adjustment, or massage.
"very difficult to study or compare different procedures"
In 2005 a Cochrane Review of 35 different studies, involving 2861 people with low back pain, compared acupuncture with conventional and "alternative" treatments. They found that acupuncture is no more effective than conventional therapies.
Many of these studies are plagued with design problems because the accepted standard is a double blinded study. In double blinded studies the practitioner and the patient must be unaware of which treatment a patient is receiving. While that may work well for comparing medications, it makes it very difficult to study or compare different procedures, such as acupuncture for back pain.
"theories have been advanced as to how acupuncture might work"
Because acupuncture fits so poorly into the framework of western medicine, several different theories have been advanced as to how acupuncture might work. The gate control theory of pain, the neurohormonal theory, and placebo effect have all been presented.
The gate control theory of pain postulates that the perception of pain is a combination of the excitation and inhibition of different pain pathways and by affecting these pathways acupuncture may inhibit the perception of pain.
"sham acupuncture and acupuncture have yielded similar results"
The neurohormonal theory contends that the perception of pain in the brain can be blocked by the release of neural hormones. Studies seem to indicate that acupuncture can cause the release of natural endorphins in the brain. Endorphins are known to bind to opioid receptors and block pain.
In some studies sham acupuncture and acupuncture have yielded similar results, causing some researchers to consider the placebo effect as responsible for the pain relief from acupuncture.
More work needs to be done in all of these areas, before any reliable conclusions can be made about why acupuncture does seem to be effective, in some situations, and with some people.
The World Health Organization has reviewed and analyzed the evidence and published a list. On this list they have included all of the diseases, symptoms, and conditions, which have been shown, in clinical trials, to be effectively treated with acupuncture. Included on this list, among others, is low back pain, sciatica, and neck pain.
The National Institute of Health has concluded that, "There is sufficient evidence of acupuncture's value to expand its use into conventional medicine."
The American Academy of Medical Acupuncture states: "In the United States, acupuncture has its greatest success and acceptance in the treatment of musculoskeletal pain."
Given these recommendations, and the fact that there is little or no risk involved, a trial of acupuncture for back pain seems reasonable.