While recently doing research for a patient, I came across this quote on the Mayo clinic website: “When performed properly by trained practitioners, acupuncture has proved to be an effective therapy for back pain. Several studies have found that acupuncture can help reduce chronic back pain and improve daily function”.
My first thought upon reading the article, was “we’ve (acupuncture) arrived.” When I started studying this medicine almost 10 years ago, one of the biggest issues we worried about was credibility in the medical community. Now, one of the most conservative groups of the medical establishment is promoting acupuncture as an effective way to treat back pain. This is a huge deal- both for us as practitioners and for the many patients who suffer from pain conditions.
Did you know back pain is the leading pain condition for which patients seek doctor’s office visits?.2 Estimates show that about 30 million people at any one time have back pain and the 60-90% of people will experience back pain at some point in their lifetime3.
Like doctor’s offices, back pain is the most prevalent pain condition we treat in our acupuncture clinic. Patients are always telling me about all of their previous treatments that didn’t work for them. We see patients both pre and post surgery. Sometimes the post surgery patients are in worse shape than before their surgery. Patients are frustrated with their care.
Current treatment options include rest, ice, heat, cortisone injections, muscle relaxers/ pain medication, and surgery. Most acute back pain will resolve itself in 4-6 weeks, but no one wants to be in pain and just wait for it to get better. The problem is that most of these treatments don’t work well.
Take a look at these statistics from a series of recent reports on the issues of conventional treatment for back pain.
According to a 2007 consumer reports article, the number one most overused medical treatment is back surgery4. Reports show a 423% increase in Medicare expenditures for opioids used in the treatment of back pain, a 307% increase in lumbar MRI’s and a 629% increase in steroid injections5. Unfortunately, studies have consistently shown that these huge increases in spending on these interventions have not led to any significant decreases in patient suffering or disability.
Perhaps the most troubling information is regarding prescription pain medication. Prescriptions for opiates have gone up tenfold in the last 20 years. In 2007, there were 21 million prescriptions filled for opioid painkillers. From 1990-2007, deaths from opiate overdoses have risen 400% to over 27,000 annually6.
A series of reviews by the The Cochrane Collaboration shed some doubt on the effectiveness of opiate use in the treatment of chronic low back pain: ” there remain few high-quality trials assessing their efficacy… Based on our results, the benefit of opioids in clinical practice for the long-term management of chronic [low back pain] remains questionable.7″ They also reported limited information on the effectiveness of opiate use longer than 16 weeks8.
Now, check out the results from a 2009 study funded by the NIH. Acupuncture scored better than conventional treatment for chronic low back pain. Patients received twice weekly acupuncture for three weeks, then weekly acupuncture for four weeks, for a total of ten visits. After eight weeks, the acupuncture groups had significantly more benefit than the conventional treatment group. Benefits were reported to last for a full year.9 In a German study from 2007, investigators found that acupuncture was almost twice as effective as the “usual care” for low back pain (which included medications, rest, and physical therapy)10.
After successfully treating back pain patients for several years, it is extremely satisfying for us to finally see mainstream medical authorities like the Mayo Clinic and the NIH formally acknowledging acupuncture’s efficacy. So if someone you care about is suffering from back pain, and they are frustrated with their progress or treatment options, have them call us to set up a free consultation. Even the Mayo Clinic thinks that it’s a good idea.
2. Overtreating Chronic Back Pain: Time to Back Off? Journal of the American Board of Family Medicine. Richard A. Deyo MD, MPH; Sohail K. Mizra , MD, MPH; Judith A. Turner PhD; Brook I. Martin, MPH. 22 (1): 62. 2009
3. ConsumerReports.org. 10 Overused Tests and Treatments. 2007
4. Overtreating Chronic Back Pain: Time to Back Off? Journal of the American Board of Family Medicine. Richard A. Deyo MD, MPH; Sohail K. Mizra , MD, MPH; Judith A. Turner PhD; Brook I. Martin, MPH. 22 (1): 62. 2009
5. The New Drug Crisis: Addiction by Prescription. Kluger, Jeffrey. Time.com. Sept 13, 2010
6. Deshpande A, Furlan A, Maillis-Gagnon A, Atlas S, Turk D. Opioids for chronic low-back pain. Cochrane Database Syst Rev 2007; 18: CD004959.
7. Systematic Review: Opioid Treatment for Chronic Back Pain: Prevalence, Efficacy, and Association with Addiction Bridget A. Martell, MD, MA; Patrick G. O’Connor, MD, MPH; Robert D. Kerns, PhD; William C. Becker, MD; Knashawn H. Morales, ScD; Thomas R. Kosten, MD; and David A. Fiellin, MD. January 16, 2007 vol. 146 no. 2 116-127
8. A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain. Daniel C. Cherkin, PhD; Karen J. Sherman, PhD; Andrew L. Avins, MD, MPH; Janet H. Erro, RN, MN; Laura Ichikawa, MS; William E. Barlow, PhD; Kristin Delaney, MPH; Rene Hawkes, BA; Luisa Hamilton, MD; Alice Pressman, MS; Partap S. Khalsa, DC, PhD; Richard A. Deyo, MD, MPH. Arch Intern Med. 2009;169(9):858-866. Vol. 169 No. 9, May 11, 2009Vol. 169 No. 9, May 11, 2009
9. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Haake M, Müller HH, Schade-Brittinger C, Basler HD, Schäfer H, Maier C, Endres HG, Trampisch HJ, Molsberger A. Arch Intern Med. 2007 Sep 24;167(17):1892-8.