Back pain can affect anyone at any age and most people will suffer from it at some point in their lives. It is the UK's leading cause of disability and one of the main reasons for work-related sickness absence.
The condition affects more than 1.1 million people in the UK, with 95% of patients suffering from problems affecting the lower back. Back pain currently costs the NHS and community care services more than £1 billion each year*. Most lower back pain is caused not by serious damage or disease, but by sprains, muscle strains, minor injuries, or a pinched or irritated nerve. It can also occur during pregnancy, or because of stress, viral infection or a kidney infection.
How acupuncture can help
Research has shown that acupuncture is significantly better than no treatment and at least as good as (if not better than) standard medical care for back pain (Witt 2006; Haake 2007; Cherkin 2009; Sherman 2009a). It appears to be particularly useful as an adjunct to conventional care, for patients with more severe symptoms and for those wishing to avoid analgesic drugs (Sherman 2009a, 2009b; Lewis 2010). It may help back pain in pregnancy (Ee 2008) and work-related back pain, with fewer work-days lost (Weidenhammer 2007; Sawazaki 2008). Acupuncture has in some meta-analyses been found superior to sham acupuncture (Hopton 2010) while in others the advantage was not statistically significant (Yuan 2008; Ammendolia 2008). The sham interventions are not inactive placebos, but effectively different versions of acupuncture, so their value in evaluating treatment efficacy is highly questionable (Sherman 2009a). (See Table overleaf).
Acupuncture can help back pain by:
- providing pain relief - by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurohumoral factors and changes the processing of pain in the brain and spinal cord (Pomeranz 1987; Zhao 2008).
- reducing inflammation - by promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007;Zijlstra 2003).
- improving muscle stiffness and joint mobility - by increasing local microcirculation (Komori 2009), which aids dispersal of swelling and bruising.
- reducing the use of medication for back complaints (Thomas 2006).
- providing a more cost-effective treatment over a longer period of time (Radcliffe 2006;Witt 2006).
- improving the outcome when added to conventional treatments such as rehabilitation exercises (Ammendolia 2008; Yuan 2008).
The National Institute for Health and Clinical Excellence guidelines on best practice now recommend that GPs offer a course of 10 sessions of acupuncture as a first line treatment for persistent, non-specific low back pain*
* National Institute for Health and Clinical Excellence clinical guideline 88 - Low back pain. www.nice.org.uk/CG88
About traditional acupuncture
Acupuncture is a tried and tested system of traditional medicine, which has been used in China and other eastern cultures for thousands of years to restore, promote and maintain good health. Its benefits are now widely acknowledged all over the world and in the past decade traditional acupuncture has begun to feature more prominently in mainstream healthcare in the UK. In conjunction with needling, the practitioner may use techniques such as moxibustion, cupping, massage or electro-acupuncture. They may also suggest dietary or lifestyle changes.
Traditional acupuncture takes a holistic approach to health and regards illness as a sign that the body is out of balance. The exact pattern and degree of imbalance is unique to each individual. The traditional acupuncturist's skill lies in identifying the precise nature of the underlying disharmony and selecting the most effective treatment. The choice of acupuncture points will be specific to each patient's needs. Traditional acupuncture can also be used as a preventive measure to strengthen the constitution and promote general well-being.
An increasing weight of evidence from Western scientific research (see overleaf) is demonstrating the effectiveness of acupuncture for treating a wide variety of conditions. From a biomedical viewpoint, acupuncture is believed to stimulate the nervous system, influencing the production of the body's communication substances - hormones and neurotransmitters. The resulting biochemical changes activate the body's self-regulating homeostatic systems, stimulating its natural healing abilities and promoting physical and emotional well-being.
About the British Acupuncture Council
With over 3000 members, the British Acupuncture Council (BAcC) is the UK's largest professional body for traditional acupuncturists. Membership of the BAcC guarantees excellence in training, safe practice and professional conduct. To find a qualified traditional acupuncturist, contact the BAcC on 020 8735 0400 or visit www.acupuncture.org.uk
The NHS Choices site mentions acupuncture being recommmended by NICE : http://www.nhs.uk/Conditions/Acupuncture/Pages/What-is-it-used-for.aspx
BackCare is a national charity that aims to reduce the impact of back pain on society by providing information, support, promoting good practice and funding research- visit their page about acupuncture : http://www.backcare.org.uk/360/Acupuncture.html