Recommending Acupuncture for Back Pain

Back pain has a huge impact on a person.  It is one of the most common reasons to call out of work in fact.  Acupuncture has been used for back pain for millennia and has been gaining acceptance as an effective and safe treatment.

Within recent years, the New England Journal of Medicine has written in favor of acupuncture for back pain.  The authors, all respected and established researchers, carefully analyze the current situation with regards to back pain, and even though there is controversy in the research, recommend treatment.

Acupuncture and Moxa for Back Pain

Some acupuncture skeptics ask why would these scientists make a recommendation in favor of acupuncture even though the research is unclear? The answer is easy, because acupuncture works and it is very safe.

The problem with the research is not that acupuncture does not work.  But that it is very difficult to create a research study with acupuncture.  In this research study, the acupuncture group was not different from the placebo acupuncture group.  But both the acupuncture and the acupuncture placebo groups were better than standard treatment.  Yes, you read that correctly, the placebo acupuncture was better than conventional treatment. How could this be?…

The Ouch Point Dilemma

Creating a placebo acupuncture treatment has been a “pain” (pardon the pun) for many years.  Study after study shows that acupuncture does not work better than the placebo.  Yet, at the same time, both the acupuncture and the placebo have a clinical effect which is better than conventional treatment.   Why?

First, there is the ouch point dilemma.  Ouch points are points which are sensitive and tender when you press them. In a treatment for back pain I will use these ouch points to relieve the pain.   Often they are not classical acupuncture points, rather they are simply on the muscle in the area of the pain sometimes called a trigger point.  When an acupuncture investigator selects points for the placebo treatment, they use points off of the standard acupuncture channels.  Many of the non-channel point may be ouch points in a given patient in the study and therefore may  actually be treating his pain.

Second, designing a placebo needle that does not have an effect on the is very difficult.  Often they use a needle with a retractable tip that does not puncture the skin.  This is much like a magicians sword which retracts the blade as he stabs his assistant.  Other needles may be light touch needle, or even toothpicks, that gently prick the skin. But this too may have a physiological effect.  Some styles of acupuncture use this light tapping as a way to relieve pain.

In the end, acupuncture is a physical medicine.  It is difficult to create a placebo intervention that does not have a physiological reaction with the body.

Acupuncture is a safe recommendation 

The researchers recommend acupuncture for back pain because it is safe and it works better than conventional treatment.  People are suffering with pain everyday and study after study show there is minimal risk of severe side effects and acupuncture reduces pain.

To those with back pain it does not matter if it works better than a placebo.  They just need to feel better.

Joseph Alban, L.Ac.
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