Updated: Sep 2
Explore the evidence behind the 3,000-year-old healing practice of Acupuncture
Chronic low back pain is a pretty big public health problem both in the U.S. and Europe. Many people with chronic low back pain are prescribed countless numbers of opioids from their healthcare providers to help manage their pain. Yet, despite the hundreds of reported accounts of the misuse, addiction, overdose, and death every day from prescribed opioids, many healthcare providers continue to prescribe these drugs without discussing integrative or holistic treatments to a patient's care plan.
Yet, the question some of us want to know is, why?
Why do some healthcare providers continue to prescribe pills?
There are several other "non-pharmacological" approaches to decreasing pain levels and improving patients' health and wellbeing. However, today's healthcare system has made it much more accessible and affordable for people to take the medications prescribed by doctors than to try holistic care. Despite the side effects of prescription drugs, "alternative medicine" has been perceived as a stigma in modern medicine due to insufficient research on the safety and effectiveness of specific therapies. This has caused many doctors to refrain from referring their patients to therapies outside of their conventional practice.
However, there has been growing research and an overwhelming amount of positive responses on what is called, "integrative medicine."
Compared to alternative medicine, integrative medicine is the practice of medicine which encompasses collaborative, whole-person approaches to health care. Many institutions have been incorporating integrative medicine over the past several years, such as Mayo Clinic, Stanford Medicine, Northwestern Medicine, John Hopkins Hospital, and more. Unlike alternative medicine, which is a term that describes medical treatments that are used instead of conventional therapies, integrative medicine embraces all evidence-informed disciplines, both conventional and complementary & alternative in order to achieve optimal health and well-being.
Nevertheless, the answer we all want to know is, beyond medication, what is the solution for those suffering from chronic low back pain?
Non-pharmacological approaches to managing chronic low back pain are out there. And I'm here to help break down some of that tedious yet fascinating research on an ancient, yet evidence-based form of healing that has been rapidly growing in the West for well over 100 years.
Say hello to my little friend: Acupuncture.
Acupuncture is an ancient form of Traditional Chinese Medicine which pre-dates recorded history with roots in the Taoist tradition close to over 2000 years ago. Acupuncture works with the flow of Qi (energy) and Xue (blood) in the body through distinct energetic pathways called meridians.
Acupuncture typically involves placing hair-thin needles in various pressure points (called acupoints) throughout the body, which corresponds to specific ailments or imbalances within the body. Stimulating these points may relieve pain by releasing endorphins, the body's natural pain-killing chemicals, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood.
It's ancient! So what's the science behind acupuncture?
According to Healthline, acupuncture works for chronic low back pain by:
Stimulating the nervous system. Trigger points stimulated by acupuncture could release chemicals from the spinal cord, muscles, and brain. Some of these could be naturally pain-relieving.
Releasing opioid-like chemicals produced in the body. Along the same lines as the theory above, acupuncture may release pain-relieving chemicals. These naturally occur in the body and have similar properties to opioid pain relievers. (Hydrocodone or morphine are examples.)
Releasing neurotransmitters. These are hormones that send messages regulating the on/off mechanisms of various nerve endings. Acupuncture may stimulate some that shut off the pain.
Triggering electromagnetic impulses in the body. These impulses can help speed the body's way of handling pain, including the release of endorphins.
But, is Acupuncture effective?
Don't worry; I got your "back." I've broken down some of the robust research jargon from three scholarly publications - two randomized controlled trials and one systemic review. Let's dive in:
P.S. A randomized controlled trial is a type of clinical trial used to find out which treatment is best by making a fair comparison between a new treatment and an existing treatment two (or more) existing treatments a new treatment and no treatment, or a placebo (where there is no current treatment)
A systemic review summarizes the results of carefully designed healthcare studies (aka controlled trials). It provides a high level of evidence on the effectiveness of treatments.
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies.
Study #1: 2,700 Patients Try Acupuncture
In 2013, The American Journal of Chinese Medicine published a study that showed the effectiveness of acupuncture therapy on 2,700 patients diagnosed with chronic low back pain. These studies compared the results of acupuncture with sham acupuncture (aka fake acupuncture) and other treatments.
Compared with no treatment and placebo treatment, acupuncture achieved better outcomes for the patients in terms of pain relief, functional improvement, disability recovery and better quality of life.
So, does it work?:
"For chronic low-back pain, acupuncture was determined to be more effective for pain relief than no treatment or sham treatment, in measurements taken up to three months.
Acupuncture was also determined to be more effective for improving function than no treatment in the short-term."
In conclusion, acupuncture:
Study #2: Acupuncture on 300 patients
According to a 2006 randomized controlled trial by the University Medical Center, Berlin, Germany, 298 patients with chronic low back pain were selected to be treated with acupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or a waiting list control (a group of untreated patients during a study, that eventually go on to receive the treatment at a later date).
After 12 sessions (per patient) over eight weeks, patients completed two standardized questionnaires three times: one at week 8, one at week 26, and one at week 52.
Between week 0 and week 8, patients in the acupuncture and minimal acupuncture groups reported a decrease in pain intensity.
So, does it work?:
"Acupuncture was more effective in improving pain than no acupuncture treatment in patients with chronic low back pain."
However, no significant differences were identified between acupuncture and minimal acupuncture treatments.
In conclusion, acupuncture:
Study #3: 25 clinical trials summarized
In a 2013 study posted by Spine Journal, a systemic review and meta-analysis of 25 randomized controlled trials evaluated the effectiveness of acupuncture for non-specific chronic low back pain.
Acupuncture may have a favorable effect on self-reported pain and functional limitations on non-specific chronic low back pain.
Acupuncture had a clinically meaningful reduction in:
Reduced levels of self-reported pain when compared with sham (fake acupuncture)
Improved function when compared with no treatment immediately after treatment
When compared to medications (NSAIDs, muscle relaxants, and analgesics) there was a significant difference between two groups that were studied, but the differences were too small to be of any clinical significance
So does it work?
“For chronic low back pain, acupuncture may have a favorable effect on self-reported pain and functional limitations on non-specific chronic low back pain.”
The study also reported the results listed should be interpreted in the context of the limitations identified in the study.
In conclusion, acupuncture:
Reduced levels of pain
Sounds too good to be true! Is Acupuncture safe?
Serious complications are known to be extremely rare when a qualified, certified practitioner performs acupuncture.
The risk of infection is also minimal with the use of single-use, disposable needles being the practice standard in the U.S.
What are the side effects?
Common side effects include soreness and minor bleeding or bruising where the needles were inserted.
As always, be sure to seek and follow relevant directions from your physician or other healthcare professional before using this treatment.
How do I find a credible acupuncturist?
Thankfully, our team at Zaya is building the first digital healthcare platform to bridge the gap between Western and Eastern Medicine. We are creating a global movement to help people find affordable, evidence-based, high-quality care.
But before we launch this bad boy, we want to share as much helpful content as possible to help you in your search for finding the right acupuncturist.
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Disclaimer: All opinions expressed in this blog post should not be taken as medical advice in any form. Please consult a healthcare professional for any questions or issues regarding your health.