To Your Health

Is acupuncture safe and helpful when treating back pain?

Q. My teenage son has suffered back pain all his life, with almost no help from traditional medical treatment. In desperation we have recently started acupuncture treatments that seem to be starting to help. Is acupuncture safe, and what is the basis for thinking it would work?

A. In spite of a long history of use in China, acupuncture remains on the far fringe of mainstream medicine. It is a mystery to most people in the West that a few thin needles inserted in certain specific places could relieve pain or have any benefits at all.

Acupuncture is based on the theory of qi (or chi) energy, energy that courses through channels in the body called meridians. Specific acupuncture points on the channels are commonly accepted, and practitioners achieve their therapeutic effects by stimulating these points to increase the flow of energy or qi. The system is very complex, since both channels and acupuncture points are anatomically invisible, but the acupuncture points specified 2,200 years ago are still in use today.

The laws of most states require disposable one-time-use sterilized needles for nonphysician acupuncturists, though physicians are allowed to use needles sterilized in the same way as are surgical instruments. Because bleeding is absent or minimal with acupuncture, surgical gloves are not required. No case of transmission of an infectious disease to a patient has been documented in medical literature

Chronic pain, including back pain and headache, is one of the most common reasons people seek help through acupuncture. An estimated 80% of the world's population will suffer from such pain at some point in their lives. There is no medical consensus on the treatment of lower-back pain, and the use of acupuncture for this condition has increased dramatically in the past few decades, based to a large extent on placebo-controlled studies that have validated it as a reliable method of pain relief.

A study published in 2001 in the Clinical Journal of Pain provides evidence that acupuncture is a safe and effective procedure for lower-back pain and that it can maintain benefits for six months or longer without producing the negative side effects that often accompany analgesics. Fifty patients suffering chronic lower-back pain for at least six months were recruited for two months of weekly acupuncture treatment. They had tried a variety of other therapies with no success. Patients recorded pain and other information such as sleep quality and activity level in "pain diaries." In the acupuncture group, both morning and evening pain scores were lower than starting scores and continued to decrease over the six months of treatment. In the placebo group, pain scores were several points higher after one month than they were at the start, and remained higher throughout the study. Activity levels and sleep were also improved in the acupuncture group. The total intake of analgesics diminished by 20% in the acupuncture group, but not the placebo group.

In 1997 the National Institute of Health published a consensus statement saying there is sufficient evidence to support the use of acupuncture for some conditions, including back pain. Use of acupuncture does not mean you cannot use conventional medical therapies at the same time, and often both are utilized successfully.

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Key words:acupuncture, chronic back pain

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