02 November 2007

Acupuncture for back pain

Acupuncture 'best therapy for back pain'

By Nic Fleming, Science Correspondent

Acupuncture can provide significantly more relief from lower back pain than conventional therapies, scientists say.

The Chinese needle treatment was 74 per cent more likely to lead to a sustained reduction in pain or improved ability to function normally than physiotherapy, medication and advice on exercise, according to German researchers.

Acupuncture 'best therapy for back pain'
Scientists say both acupuncture and
‘sham acupuncture’ are beneficial

However, the study also found "sham acupuncture" — in which needles are applied away from points usually used in traditional Chinese medicine — to be almost as effective, suggesting that the positive effects may have more to do with the way the body deals with pain than with the specific points where the needles are applied.

Dr Michael Haake, of the University of Regensburg in Bad Abbach, whose research was published in the journal Archives of Internal Medicine, said: "Acupuncture gives physicians a promising and effective treatment option for chronic low back pain, with few adverse effects or contra-indications.

"The improvements in all primary and secondary outcome measures were significant and lasted long after completion of treatment. The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals or processing of pain signals by the central nervous system."

Dr Haake and colleagues carried out a clinical trial involving 1,162 patients who had experienced chronic low back pain for an average of eight years.
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All participants underwent 10 half-hour sessions in five weeks. One group had acupuncture, while another had sham acupuncture.

The final group had conventional therapy consisting of a combination of medication, physical manipulation and exercise.

A successful response was defined as a 33 per cent reduction in pain or a 12 per cent improvement in ability to function normally. Both were assessed using questionnaires.

Six months after the trial was completed, 47.6 per cent of those in the real acupuncture group had responded to their treatment, compared to 44.2 per cent of the sham acupuncture group and 27.4 per cent in the conventional therapy group.

When a patient goes to see their GP about lower back pain in Britain, the doctor will firstly check for serious conditions, such as tumours or rheumatoid arthritis, before providing advice about exercise and the use of painkillers.

If the problem is not resolved within several weeks, patients are sometimes offered manipulation therapies including chiropractic, osteopathy or physiotherapy.

A survey of 2,240 people with back problems carried out by the charity BackCare in 2005 found that of those who had tried acupuncture 30 per cent said it had no effect, 41 per cent believed it provided only temporary relief and 19 per cent said it provided significant, sustained improvements.

Nia Taylor, the chief executive of BackCare, said: "We know from talking to patients that they are often dissatisfied with the attention they receive from their GPs. So-called alternative therapies such as acupuncture often provide longer consultation periods, and that in itself can be beneficial."

The NHS spends more than £1 billion per year on back pain, including £512?million for hospital treatment, £141 for GP consultations and £150 million on physiotherapy.

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