New Finding - Acupuncture Beats Drugs for Lower Back Pain

on 19 March 2013.

A new study finds acupuncture more effective for the treatment of lower back pain than a nonsteroidal anti-inflammatory drug (NSAID) injection of diclofenac. Researchers applied acupuncture needles to patients with acute lower back pain and compared results with subjects injected with the NSAID medication. The drug diclofenac is used to reduce both inflammation and to reduce pain. The research uncovered important facts. The group receiving acupuncture experienced both greater pain relief and less physical disability than did the drug group. After two and then four weeks after treatment, the acupuncture group continued to have greater improvements than the group receiving drug therapy.

Acupuncture applied to the back is depicted here. Acupuncture TreatmentThe researchers note that the style of acupuncture used in the study was that of motion style acupuncture. This requires movement of the patient’s body either actively or passively during the acupuncture treatment. The results showed that acupuncture effectively reduces both pain and disability and that acupuncture is more effective than diclofenac injections for the treatment of acute lower back pain.

These findings concur with those published in the Journal of Anesthesiology Clinical Research by another group of researchers. Here, the investigators discovered that acupuncture is effective for neck and lower back pain relief. Similar to the aforementioned study, these researchers found that acupuncture is sometimes more effective than nonsteroidal anti-inflammatory medications. Yet another group of researchers independently came up with more similar results. Investigators found 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).”

Cost-Effective
A great deal of acupuncture research for the treatment of lower back pain has emerged within the last year. Recently, researchers in Calgary, Alberta discovered that acupuncture is not only effective for the treatment of lower back pain but is also cost-effective. The investigators found that the use of acupuncture for the treatment of lower back pain reduces overall healthcare spending.

Researchers from Hunan University of TCM (Traditional Chinese Medicine) decided to take an important step in yet another recent clinical investigation. They compared a standard application of acupuncture needles with the application of needles using the manual acupuncture technique of Dragon and Tiger Fighting. The researchers concluded that the use of the Dragon and Tiger Fighting technique greatly enhanced the efficaciousness of acupuncture for the treatment of lower back pain. This technique showed greater clinical improvements in lower back pain patients than did the uniform reinforcing-reducing method. In addition, the Dragon and Tiger Fighting manual acupuncture technique also demonstrated greater clinical efficacy than standard physiotherapy.

Medicare
The data continues to mount showing the clinical efficacy of acupuncture for the treatment of lower back pain. Additionally, the cost effectiveness of acupuncture for the treatment of pain found in recent studies suggests that acupuncture is an important modality needing greater inclusion in the healthcare system. Under Obamacare (Patient Protection and Affordable Care Act), the US federal government has left the task of selecting specific preventative and complementary medical services for inclusion in the health insurance system up to individual states. Maryland and California subsequently chose to include acupuncture health insurance coverage for all of their citizens with small group and individual health insurance plans begining in 2014. In the meantime, the US federal government has not designated being a licensed acupuncturist as a standalone profession despite statewide legislation regulating educational and licensing standards. The Bureau of Labor Statistics (BLS) does not recognise a licensed acupuncturist as a profession but instead lists acupuncture as a procedure performed by nurses and chiropractors. The lack of a BLS listing prevents acupuncture from becoming covered under the Medicare system.

President Obama
Section 3502 of the new health reform law signed by President Obama states that primary health care practitioners must “provide coordination of the appropriate use of complementary and alternative (CAM) services to those who request such services.” The Maryland and California governors and state legislatures have already chosen acupuncture as a covered benefit. On the federal level, recognition of acupuncture benefits awaits a formal BLS listing and a formal response by President Obama to a recent petition requesting that acupuncturists become recognized as healthcare providers under the Social Security Act. President Obama has long recognized acupuncture as an effective modality. During his first run for the President of the United States, Barak Obama acknowledged the efficaciousness of acupuncture for the treatment of migraines during a public question and answer period of his campaign. While the recent petition to the White House triggers an automatic response by the White House on the inclusion of acupuncture into the Medicare system, it is unclear whether an administration spokesperson will draft the response or whether President Obama will speak out on the issue. Recent studies showing the cost-effectiveness of acupuncture in the treatment of chronic and acute pain syndromes suggests that there will be an overall favorable response by the White House given the administration's stance on improving patient outcomes while controlling costs.

References:
Shin, Joon-Shik, et al. "Effects of motion style acupuncture treatment (MSAT) in acute low back pain patients with severe disability: A multicenter, randomized, controlled comparative effectiveness trial." PAIN (2013).

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.

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.

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.

Zhao, F., et al. "Efficacy observation of nonspecific low back pain treated with the dragon-tiger fighting needling method]." Zhongguo zhen jiu= Chinese acupuncture & moxibustion 32.6 (2012): 507.