October 2007 >
Study: Acupuncture Works
for Back Pain
Study: Acupuncture Works for Back Pain
By Carla K. Johnson
CHICAGO (AP) — Fake acupuncture works nearly as well as the real thing
for low back pain, and either kind performs much better than usual care,
German researchers have found. Almost half the patients treated with
acupuncture needles felt relief that lasted months. In contrast, only
about a quarter of the patients receiving medications and other Western
medical treatments felt better.
Even fake acupuncture worked better than conventional care, leading
researchers to wonder whether pain relief came from the body's reactions
to any thin needle pricks or, possibly, the placebo effect.
"Acupuncture represents a highly promising and effective treatment
option for chronic back pain," study co-author Dr. Heinz Endres of Ruhr
University Bochum in Bochum, Germany, said in an e-mail. "Patients
experienced not only reduced pain intensity, but also reported
improvements in the disability that often results from back pain and
therefore in their quality of life."
Although the study was not designed to determine how acupuncture works,
Endres said, its findings are in line with a theory that pain messages
to the brain can be blocked by competing stimuli.
Positive expectations the patients held about acupuncture — or negative
expectations about conventional medicine — also could have led to a
placebo effect and explain the findings, he said.
In the largest experiment on acupuncture for back pain to date, more
than 1,100 patients were randomly assigned to receive either
acupuncture, sham acupuncture or conventional therapy. For the sham
acupuncture, needles were inserted, but not as deeply as for the real
thing. The sham acupuncture also did not insert needles in traditional
acupuncture points on the body and the needles were not manually moved
After six months, patients answered questions about pain and functional
ability and their scores determined how well each of the therapies
In the real acupuncture group, 47 percent of patients improved. In the
sham acupuncture group, 44 percent did. In the usual care group, 27
percent got relief.
"We don't understand the mechanisms of these so-called alternative
treatments, but that doesn't mean they don't work," said Dr. James Young
of Chicago's Rush University Medical Center, who wasn't involved in the
research. Young often treats low back pain with acupuncture, combined
with exercises and stretches.
Chinese medicine holds that there are hundreds of points on the body
that link to invisible pathways for the body's vital energy, or qi. The
theory goes that stimulating the correct points with acupuncture needles
can release blocked qi.
Dr. Brian Berman, the University of Maryland's director of complementary
medicine, said the real and the sham acupuncture may have worked for
reasons that can be explained in Western terms: by changing the way the
brain processes pain signals or by releasing natural painkillers in the
In the study, the conventional treatment included many methods:
painkillers, injections, physical therapy, massage, heat therapy or
other treatments. Like the acupuncture patients, the patients getting
usual care received about 10 sessions of 30 minutes each.
The study, appearing in Monday's Archives of Internal Medicine, used a
broad definition for low back pain, but ruled out people with back pain
caused by spinal fractures, tumors, scoliosis and pregnancy.
Funding came from German health insurance companies, and the findings
already have led to more coverage in Germany of acupuncture.