WebMD Medical News
Louise Chang, MD
Sept. 24, 2007 -- Acupuncture proved to be more effective than conventional
lower back pain treatments in a new study, but it was no more effective than a
sham needle procedure.
The German study compared outcomes among 1,162 patients with chronic low
back pain treated with traditional Chinese acupuncture; sham acupuncture; or a
conventional approach to treating back pain using drugs, physical therapy, and
The study is the largest investigation of acupuncture vs. conventional
nonsurgical treatment for lower back pain ever reported, researchers say.
"Acupuncture represents a highly promising and effective treatment
option for chronic back pain," researcher Heinz Endres, MD, tells WebMD.
"Patients experienced not only reduced pain intensity, but also reported
improvements in the disability that often results from back pain -- and
therefore in their quality of life."
Endres says up to 85% of people will suffer from low back pain at some point
in their lives. The pain may last for a few days or continue as chronic low
back pain for months and years.
While a recent review of research showed acupuncture to be useful for the
treatment of low back pain when given in addition to other therapies, the
latest study was designed to determine if acupuncture is an effective treatment
on its own.
Acupuncture was delivered in 10, 30-minute sessions conducted over six
weeks. Patients who received conventional treatments had a similar number of
total treatments, which included exercise, pain medication, and nonsteroidal
anti-inflammatory drugs (NSAIDs).
The acupuncture groups were allowed to use medication for acute episodes of
back pain only. This consisted of NSAID use no more than two days a week during
the treatment period.
Traditional acupuncture involved inserting needles at fixed points and
depths on the body and manipulating the needles in accordance with ancient
With the sham treatment, needles were inserted in the lower back at
shallower depths at non-acupuncture points and the needles were not
Patients who got the traditional and sham acupuncture treatments were almost
twice as likely to report treatment-related responses six months later as
patients who did not have acupuncture.
Responses were defined as a 33% improvement in pain or a 12% improvement in
"Because acupuncture has a low risk of side effects and few
contraindications, it should be added to the catalogue of treatments
recommended for acute and chronic back pain, even though -- just as for any
other form of treatment -- there will always be some patients who do not
respond," Endres says.
Several earlier studies involving patients with chronic pain have shown
similar benefits for traditional and sham acupuncture.
A 2005 analysis of 33 back pain studies did show a treatment advantage for
traditional acupuncture, but a researcher involved in the analysis says more
recent studies challenge this finding.
"The evidence as a whole suggests that the benefits of true acupuncture
over sham acupuncture are almost clinically irrelevant," Eric Manheimer,
MS, of the University of Maryland Center for Integrative Medicine tells WebMD.
"The reasons for this are not really clear. It may be that putting the
needles anywhere stimulates some sort of analgesic effect."
Acupuncture is still considered an alternative treatment for low back pain
in the U.S., but this is no longer the case in Germany. Based on findings from
the newly reported study, it is now covered by state health insurance.
Endres says acupuncture is a clearly useful treatment for low back pain,
even if we don't understand why.
"Just because we cannot explain exactly the mechanism by which a
treatment works, doesn't mean that it doesn't work," he says.
SOURCES: Haake, M. Archives of Internal Medicine, Sept. 24, 2007; vol
167: pp 1892-1899. Heinz G. Endres, MD, Eric Manheimer, MS, research associate,
Center for Integrative Medicine, University of Maryland School of Medicine,
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