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Acupuncture May Ease Chronic Back Pain

Study Shows Acupuncture Trumps Standard Care for Back Pain Relief
By
WebMD Health News
Reviewed by Louise Chang, MD

May 11, 2009 -- The ancient technique of acupuncture helps relieve chronic back pain better than standard care such as medications or physical therapy, according to a new study.

Even more surprising, all three acupuncture techniques tested -- including a "sham" technique with toothpicks and no skin puncturing -- worked better than the usual care given for the problem.

"Acupuncture-like treatments had a positive effect overall on people's chronic back pain," says study researcher Dan Cherkin, PhD, a senior investigator at Group Health Center for Health Studies in Seattle. "It didn't matter if you inserted the needle or superficially poked [the skin]."

That finding, Cherkin says, leads to more speculation about how the centuries-old technique actually works.

The study is published in the Archives of Internal Medicine.

Cherkin and colleagues assigned 638 men and women with chronic low back pain who had never before had acupuncture to one of four groups:

•         Individualized acupuncture group. Patients received acupuncture treatment based on a customized prescription for acupuncture points.

•         Standardized acupuncture group. Patients received an acupuncture treatment considered effective by experts for chronic low back pain.

•         Simulated acupuncture group. Patients received a treatment that mimics needle acupuncture but used a toothpick in a needle guide tube without penetrating the skin.

•         Usual care group. Patients continued whatever they were doing, such as taking pain medicine or undergoing physical therapy.

Acupuncture treatments were given two times a week for three weeks, then once a week for four weeks. The researchers measured back pain-related problems and dysfunction at eight weeks, a half year, and one year after the treatments.

Participants in the trial, funded by the National Institutes of Health, were told only that the researchers were comparing three different methods of stimulating acupuncture points.

Acupuncture vs. 'Usual Care'

"The individualized acupuncture did not provide any benefit over the standardized acupuncture," Cherkin tells WebMD. "The simulated acupuncture, which did stimulate the standardized points, also had the same effect. All three did better than usual care."

Those who got any of the acupuncture treatments were more likely than those getting usual care to have a "meaningful" improvement in the dysfunction scale, which reflects the ability to engage in activities of daily living. Overall, 60% of the acupuncture-treated patients, but just 39% of the usual-care group patients, had meaningful improvements in dysfunction, the researchers found.

That translated to those in the acupuncture group being able to do more daily activities, such as going to social functions or performing household tasks, Cherkin tells WebMD.

After a year, those in the acupuncture groups were also more likely than the usual-care group to continue to have improvement in dysfunction, with up to 65% of the acupuncture-treated patients but just 50% of the usual-care patients still reporting improvements. But the improvement waned over time.

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