Acupuncture Continuing Education

Acupuncture Relief From Low Back Pain

Researchers conclude that acupuncture is effective for the treatment of chronic low back pain. A randomized, controlled trial was performed at the Dongzhimen Hospital in Beijing, China with a group of 60 participants. Acupuncture effectively decreased patient pain levels and reduced days missed from work due to low back pain. Back Points

Another study of 236 patients published in the Journal of Musculoskeletal Pain concludes that acupuncture is effective for the treatment of low back pain. A total of 14 acupuncture treatments were administered over 4 weeks in this randomized trial. The researchers concluded that acupuncture has “beneficial and persistent effectiveness against CLBP (chronic lower back pain).”

Another study investigated the effects of distal acupuncture on low back pain. Distal acupuncture involves acupuncture point selections from areas that are not located in the affected region. For this study, a single acupuncture point, LI4 (Hegu), was chosen. A group of 187 patients with chronic low back pain received 18 treatments at LI4 over a 7 week period in this controlled clinical trial. The patients demonstrated significant relief from low back pain. 

LI4 is located on the dorsum of the hand, between the 1st and 2nd metacarpal bones at the midpoint of the 2nd metacarpal bone, at the high point of the thenar eminence and distal to the transverse carpal ligament. In Traditional Chinese Medicine (TCM), acupuncture is applied to this point for the treatment of many pain related conditions including headaches, jaw pain, eye pain and toothaches. Nearby, another well known set of distal points on the hand, Yaotongxue, are often used by licensed acupuncturists for the relief of pain due to acute low back sprain. 

Hegu, LI4

A large scale analysis of a multitude of studies finds acupuncture effective for the relief of low back pain. In a meta-analysis of 11 randomized-controlled trials, researchers note that “current evidence is encouraging in that acupuncture may be more effective than medication….” They note that, “Compared with nonsteroidal anti-inflammatory drugs, acupuncture may more effectively improve symptoms of acute LBP (lower back pain).” The study eliminated variables such as the placebo effect by using sham (simulated) acupuncture controls to ensure the validity of the data.

Another study finds acupuncture effective for the treatment of neck and lower back pain. The researchers concur with prior studies demonstrating that acupuncture is effective for pain relief and that acupuncture is sometimes more effective than NSAIDs (nonsteroidal anti-inflammatory drugs). Acupuncture was determined to be effective for both long and short-term pain relief of lumbar disc herniations and cervical disc related pain.

A great deal of press has been given to the administration of healthcare within the USA. Concern over implementation of recent healthcare legislation such as the PPACA (The Patient Protection and Affordable Care Act, “Obamacare”) has received enormous news coverage. Other systems providing healthcare for all its citizens including those of Canada, the UK, Australia, Germany and France have also received attention as a result of the new USA basic standards in healthcare insurance established by the PPACA. Acupuncture research has focused on this aspect of the conversation and not only on clinical effectiveness.

Researchers in Calgary, Alberta investigated the cost-effectiveness of acupuncture for the treatment of low back pain. They discovered that acupuncture reduces the total of health services spending. A group of 201 acupuncture and 804 non-acupuncture low back pain patients were evaluated for the number of medical doctor visits required for the treatment of low back pain.

The mean age of the group was 48 years and 54% of those investigated were female. Results were tabulated as a comparison of the 1 year period prior to receiving acupuncture therapy versus the 1 year period after having had acupuncture therapy. The same period of time was evaluated for the 804 non-acupuncture patients in the control group.

Cost Effective Medicine

The acupuncture group saw doctors 49% less after having acupuncture. The non-acupuncture patients had a decrease of only 2%. The acupuncture patients total monetary cost of physician services decreased by 37%. The non-acupuncture patients had a 1% drop in cost. The researchers concluded that low back pain patients are less likely to visit medical practitioners for low back pain after having had acupuncture therapy thereby reducing overall health service expenses.

Multidisciplinary approaches have also been studied. A new study finds that acupuncture combined with massage is more effective for treating lumbar disc herniation (LDH) than coenzyme B12 injections combined with physiotherapy. Researchers randomly divided 60 patients into an acupuncture group and an injection group. The acupuncture group received acupuncture needling on myofascial pain related trigger points combined with massage. The injection group received coenzyme B12 injections combined with traction and heat therapy. The acupuncture group achieved an overall effective rate of 96.7% and the injection therapy group had an 80.0% effective rate.

Other very serious investigations found acupuncture effective for back pain related to cancer pain. Researchers conducted a randomized, placebo controlled study to investigate whether or not acupuncture reduces pain associated with pancreatic cancer. This type of cancer is often accompanied by severe abdominal or back pain. The researchers concluded that, “Electroacupuncture was an effective treatment for relieving pancreatic cancer pain.”

The acupuncture points used in the study were the Jiaji points from T8 to T12, bilaterally, for a total of 30 minutes of acupuncture needle retention time per office visit. Treatment frequency was once per day for a total of 3 days of care. The placebo control group showed little to no change in pain levels. The electroacupuncture group showed a significant reduction in pain intensity levels.

This is not an exhaustive list of all of the acupuncture research to be published in recent years. Acupuncture now has an established track record for the relief of low back pain. This is supported by clinical trials, laboratory experiments and meta-analyses. In addition, mounting evidence now finds acupuncture cost-effective for the treatment of low back pain. The slow and steady integration of acupuncture into conventional medical settings combined with acupuncture continuing education and research now brings acupuncture into the mainstream for the treatment of acute and chronic pain.


Fire Cupping

Bahrami-Taghanaki, H., Y. Liu, H. Azizi, A. Khorsand, H. Esmaily, A. Bahrami, and Zhao B. Xiao. "A randomized, controlled trial of acupuncture for chronic low-back pain." Alternative therapies in health and medicine 20, no. 3 (2014): 13.

Mingdong, Yun. Na, Xiong. Mingyang, Guo. Jun, Zhang. Defang, Liu. Yong, Luo. Lingling, Guo. Jiao, Yan. Acupuncture at the Back-Pain-Acupoints for Chronic Low Back Pain of Peacekeepers in Lebanon: A Randomized Controlled Trial. Journal of Musculoskeletal Pain. P 107-115, V 20.

Hegu Acupuncture for Chronic Low-Back Pain: A Randomized Controlled Trial. Mingdong Yun, Yongcong Shao, Yan Zhang, Sheng He, Na Xiong, Jun Zhang, Mingyang Guo, Defang Liu, Yong Luo, Lingling Guo, and Jiao Yan. The Journal of Alternative and Complementary Medicine. February 2012, 18(2): 130-136. doi:10.1089/acm.2010.0779.

Acupuncture for Acute Low Back Pain: A Systematic Review. Lee, Jun-Hwan KMD, PhD; Choi, Tae-Young PhD; Lee, Myeong Soo PhD; Lee, Hyejung KMD, PhD; Shin, Byung-Cheul KMD, PhD; Lee, Hyangsook KMD, PhD. Clinical Journal of Pain:. POST AUTHOR CORRECTIONS, 6 August 2012.

Effectiveness of Acupuncture with NSAID Medication in the Management of Acute Discogenic Radicular Pain: A Randomised, Controlled Trial. Beyazit Zencirci1, Kasim Zafer Yuksel, and Yakup Gumusalan. J Anesthe Clinic Res 2012, 3:3.

Deutsche Zeitschrift für Akupunktur. Volume 55, Issue 3, 2012, Pages 25–26. Reduced health resource use after acupuncture for low-back pain. S Moritza, MF Liub, B Rickhia, b, c, TJ Xua, P Paccagnana, H Quand. Participating institutions: Canadian Institute of Natural and Integrative Medicine, Calgary, Alberta, Canada. Alberta Health Services, Calgary, Alberta, Canada. University of Calgary, Calgary, Alberta, Canada.

Chen, Hao, Tang-Yi Liu, Le Kuai, Ji Zhu, Cai-Jun Wu, and Lu-Ming Liu. "Electroacupuncture treatment for pancreatic cancer pain: A randomized controlled trial." Pancreatology (2013).
Ting Bao, Lixing Lao, Michelle Medeiros, Ruixin Zhang, Susan G. Dorsey, and Ashraf Badros. Medical Acupuncture. September 2012, 24(3): 181-187. doi:10.1089/acu.2011.0868. The University of Maryland School of Medicine, Baltimore, Maryland.