According to a widely publicized 2002 study, the most frequent reason that most of us visit a licensed acupuncturist for care is for back pain.
According to the National Institutes of Health, up to 80 percent of the common population in the United States will suffer an incident of low back pain during their lifetimes. After respiratory ailments, low back pain is the most frequent reason Americans visit a medical doctor for treatment.
A new meta-analysis of acupuncture and the management of low back pain has recently been published in the Annals of Internal Medicine. The analysis of approximately two dozen previously published studies has establish that acupuncture is significantly more effective than sham acupuncture or no treatment in people with chronic back pain.
In their analysis, a group of scientists from the United States and Great Britain conducted a search of seven computerized databases in the U.S. and Europe from their inception through August 2004. One database was searched through February 2003.
Experts were also contacted in various countries, including the U.S., Great Britain, Germany, Sweden, Italy, Norway, and Japan, for randomized, controlled trials that compared needle acupuncture with sham acupuncture, no treatment, or other active therapies on patients with low back pain. The search produced 33 trials that met the investigators' criteria, including 23 recent trials that had not been included in previous analyses.
Excluded from the meta-analysis were eleven studies because their results could not be combined with the other studies accordingly. The remaining 22 trials were then grouped according to whether the pain being treated was acute or chronic, along with the style of acupuncture practiced and the other types of interventions used.
Data from the trials was extracted and analyzed based on the following outcomes: short-term effectiveness on pain, long-term effectiveness on pain, and short- and long-term effects on functional status and overall improvement. In addition, the quality of the trials was computed using two measurements: the Jadad quality score and the Cochrane Back Review Group quality score.
Results Of The Study:
Acupuncture was statistically significantly more effective for lower back pain than no additional treatment or sham TENS, and was an average of 61 percent more effective compared to sham acupuncture. Two studies found acupuncture to be more effective than TENS; one trial suggested that acupuncture was statistically significantly worse than massage.
Acupuncture was found to be "statistically significantly more helpful" than sham acupuncture, sham transcutaneous electrical nerve stimulation (TENS) and no additional treatment. Compared to sham acupuncture, real acupuncture was 58 percent more successful in relieving pain, which the researchers equated to an improvement of 14.5 points on a 100-point visual analogue scale. Results comparing acupuncture to other active treatments were varied, however. Acupuncture appeared more helpful in three out of four studies using real TENS and two out of three studies comparing acupuncture and pain medications, but was less successful compared to massage, and "statistically significantly less effective" than spinal manipulation.
Functional status and overall improvement. "For improving functioning," the researchers observed, "acupuncture was statistically significantly more effective than the no-additional-treatment control in the short term effects." They added, For overall improvement, acupuncture was statistically significantly more effective than the sham controls and no-additional-treatment control in both the short- and long-term effects.