Acupuncture for chronic back pain. Alternative to conventional therapy?

Abstract

Introduction: Acupuncture involves treatment of specific anatomic locations on the skin, called acupuncture points, by thin, solid, generally metallic needles. Acupuncture is one of the oldest and most commonly used forms of traditional medicine in the world—dating back approximately 2500 years. The general theory of acupuncture is based on the premise that patterns of energy called Qi (pronounced "chee") that flow throughout the body are essential for optimal health. In 1997 a National Institutes of Health (NIH) Consensus Panel discussed the role of acupuncture as a therapeutic intervention in the United States [1]. The panel experts concluded that many acupuncture studies provided equivocal results because of design, sample size, and other factors. The issue was further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, some results showed efficacy of acupuncture in adult post-operative and chemotherapy nausea and vomiting and in post-operative dental pain. There are other conditions, such as addiction, stroke rehabilitation, and chronic pain, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Acute low back pain is a painful condition that is usually self-limiting and tends to improve spontaneously over time. However, for many patients, back pain becomes a chronic or recurrent problem for which a large variety of therapeutic interventions are employed. Low back pain limits activity and is the second most frequent reason for physician visits. Previous research shows widespread use of acupuncture for low back pain. The main goal in treating back pain is to decrease pain so that patients can resume their normal activities. Traditional treatments for low back pain include drugs (analgesics, anti-inflammatory drugs, and muscle relaxants), physical therapy, back exercises, and education about ways to prevent back injury and to cope with back pain. Unfortunately, these treatments do not always help. Many patients with low back pain seek alternative treatments, such as acupuncture. Increasingly, mainstream medicine is recognizing acupuncture as an effective treatment for this disorder. It is, however, unclear whether acupuncture is an effective treatment for low back pain. Aims: To assess the effectiveness of acupuncture for treating low back pain.