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Study: Acupuncture Beats Conventional Treatment for Back Pain

German study also finds 'sham' acupuncture works as well as the traditional form

September 24, 2007

• Study: Acupuncture Beats Conventional Treatment for Back Pain • Acupuncture and Fibromyalgia • Acupuncture and Knee Pain • Study Finds Acupuncture No Help for Migraines

A new study finds that six months of acupuncture treatment -- both traditional Chinese acupuncture and the sham variety -- appears to be more effective than conventional therapy in treating low back pain.

How is that possible?

The authors of the study, published in the September 24 issue of Archives of Internal Medicine, admit they don't know but same there must be some common, as-yet unknown, element at work.

“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 and that is stronger than the action mechanism of conventional therapy,” the researchers said.

“Acupuncture gives physicians a promising and effective treatment option for chronic low back pain, with few adverse effects or contraindications. The improvements in all primary and secondary outcome measures were significant and lasted long after completion of treatment,” they said.

Michael Haake, Ph.D., M.D., and colleagues at the University of Regensburg, Bad Abbach, Germany, conducted the randomized clinical trial involving 1,162 patients (average age 50) who had experienced chronic low back pain for an average of eight years.

Patients underwent ten 30-minute sessions (approximately two sessions per week) of verum acupuncture (387 patients), sham acupuncture (387 patients) or conventional therapy (388 patients).

Verum acupuncture consisted of needling fixed points and additional points to a depth of 5 millimeters to 40 millimeters based on traditional Chinese medicine, while sham acupuncture consisted of inserting needles superficially (1 millimeter to 3 millimeters) into the lower back avoiding all known verum points or meridians.

Conventional therapy consisted of a combination of medication, physical therapy and exercise. Five additional sessions were offered to those who had a partial response to treatment (10 percent to 50 percent pain reduction).

“A total of 13,475 treatment sessions were conducted (verum acupuncture, 4,821; sham acupuncture, 4,590; conventional therapy, 4,064),” the authors write. Patients receiving the additional five sessions were 232 (59.9 percent) in the verum group, 209 (54.3 percent) in the sham group and 192 (52.5 percent) in the conventional group.

Response rate was defined as a 33 percent improvement in pain or a 12 percent improvement in functional ability. “At six months, response rate was 47.6 percent in the verum acupuncture group, 44.2 percent in the sham acupuncture group and 27.4 percent in the conventional therapy group,” the authors note. “Differences among groups were as follows: verum vs. sham, 3.4 percent; verum vs. conventional therapy, 20.2 percent; and sham vs. conventional therapy, 16.8 percent.”

While there may not be a solid explanation of how acupuncture works, anything that provides relief is a step forward, given the number of people afflicted by lower back pain.

“Low back pain is a common, impairing and disabling condition, often long-term, with an estimated lifetime prevalence of 70 percent to 85 percent,” according to the authors. “It is the second most common pain for which physician treatment is sought and a major reason for absenteeism and disability.” Acupuncture is increasingly used as an alternative therapy, but its value as a treatment for low back pain is still controversial.

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