How effective is acupuncture for chronic back pain?

SPINE study reveals effectiveness of needles, other forms of treatment

If you’ve ever considered acupuncture for chronic low back pain, here’s the good news: In the largest U.S. study of its kind, Group Health researchers found that acupuncture can help. The treatment helped people with chronic low back pain feel less bothered by their symptoms and function better in their daily activities.

But how?

Be advised that acupuncture, when compared to other forms of pain treatment, was not the hands-down winner in this research, published in the May 11, 2009 Archives of Internal Medicine. In fact, the study—called “Stimulating Points to Investigate Needling Efficacy (SPINE)”—raised questions about how the ancient practice actually works. By comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain, findings suggest that acupuncture is merely equal to other common treatments for back pain.

"Acupuncture is about as effective as other treatments for chronic back pain that have been found helpful," says study leader Daniel C. Cherkin, PhD, a senior investigator at Group Health Research Institute. "But we found that simulated acupuncture, without penetrating the skin, produced as much benefit as needle acupuncture—and that raises questions about how acupuncture works."

Fairly equal results

Dr. Cherkin and his team found that the outcomes for groups that received the needle and simulated forms of acupuncture did not differ significantly. So, although acupuncture effectively soothed low back pain, that benefit seemed to require neither tailoring acupuncture needle sites to an individual patient nor inserting needles into the skin.

"We don't know precisely why people got back pain relief from the simulated acupuncture," says study co-author Karen J. Sherman, PhD, MPH, also a senior investigator at Group Health Research Institute. "Historically, some types of acupuncture have used non-penetrating needles. Such treatments may involve physiological effects that make a clinical difference." Or it might be all about the mind-body connection. She said, "Maybe the context in which people get treatment has effects that are more important than the mechanically induced effects."

The National Center for Complementary and Alternative Medicine (NCCAM) funded the SPINE trial. "The findings of this research show that acupuncture-like treatments, including simulated acupuncture, can elicit positive responses," says Josephine P. Briggs, MD, director of NCCAM. "This adds to the growing body of evidence that something meaningful is taking place during acupuncture treatments outside of actual needling. Future research is needed to delve deeper into what is evoking these responses."

 

by Julian Rogers and Rebecca Hughes

                                                                                  


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From Group Health Research Institute

From Group Health Cooperative

Co-Researcher

Karen J. Sherman, PhD

Senior Investigator
Kaiser Permanente Washington Health Research Institute