Relief for Back Pain Comes from Acupuncture (Real or Simulated)

At some point, nearly all of us have-or will-experience back pain severe enough to interfere with work, daily activities, or recreation. In fact, it's the most common cause of job-related disability and a leading contributor to missed work. A few days of ice and rest may be all that's needed for many, but for those with chronic back pain (persisting for more than three months) finding relief can seem like an exercise in futility.

A dissatisfaction with conventional Western treatment has led many with chronic back pain to try acupuncture (it's the leading reason for visits to acupuncturists). And a new study finds that acupuncture-and simulated acupuncture--improves chronic back pain more effectively than conventional care. The research team, led by Dr. Daniel Cherkin of the Group Health Center for Health Studies in Seattle, randomly assigned the subjects (638 adults with chronic low back pain who had never been treated with acupuncture) to one of four groups. The first received a customized prescription for acupuncture points from a diagnostician. The second received standardized acupuncture, targeting points that experts consider generally effective for chronic low back pain. The third group received simulated acupuncture, which mimics needle acupuncture but doesn't involve actual penetration of the skin. The fourth group received standard medical care.

The patients in the three acupuncture groups were treated twice weekly for three weeks, and then weekly for an additional four weeks. At 8, 26 and 52 weeks, the researchers measured back-related dysfunction and asked the participants about their symptoms. Eight weeks into treatment, subjects from all three acupuncture groups improved significantly more than those who were receiving conventional treatment. While the benefits diminished over time, they lasted for a year. What's particularly interesting, is that there appeared to be no significant difference in the improvement between those receiving real or perceived acupuncture. Neither tailoring acupuncture needle sites to an individual patient nor actually penetrating the skin appeared to be necessary to get the benefits of acupuncture. "Because of the lack of highly effective medical treatments for chronic low back pain, we were pleased to find that acupuncture-like treatments were helpful for persons suffering from chronic back pain," Cherkin says. "However, the finding that real acupuncture produced no greater benefit than simulated acupuncture raises important questions about acupuncture's mechanisms of action."

"This adds to the growing body of evidence that there is something meaningful taking place during acupuncture treatments outside of actual needling. Future research is needed to delve deeper into what is evoking these responses," says Dr. Josephine P. Briggs, director of NIH's National Center for Complementary and Alternative Medicine (NCCAM), which funded the study.