A German study finds that acupuncture is better than no treatment at all, but not superior to conventional therapy

Chronic back pain, commonly defined as that lasting more than three months, is a debilitating condition that poses a major health problem. From a societal perspective, it exacts a huge burden as a result of lost productivity and significant healthcare costs through disability payments.

The individual and family experience can also be nightmarish. For one thing, chronic back pain can lead to mental illness in the form of depression. By leading to a sedentary lifestyle it can also bring on additional medical illness through weight gain and worsening cardiovascular health.

TREATMENTS

Many therapies are touted as being of benefit to chronic back pain. They range from drug treatments with anti-inflammatory medications to less conventional therapies like chiropractic manipulation and acupuncture.

In fact, great numbers of patients who cannot be helped by traditional medicine often turn to these alternative therapies.

Many of these treatments have been shown to be of dubious benefit when subjected to rigorous scientific study and are often shunned by mainstream medicine, while others are showing some possibly useful effects that warrant further study.

THE STUDY

The study referred to in this article is titled German Acupuncture Trials for Chronic Low Back Pain, Archives of Internal Medicine, Sept. 27, 2007.

The researchers concluded that acupuncture was better than no treatment at all, but not superior to conventional therapy.

However, they do state that acupuncture works when combined with other treatments like medication and exercise.

Scientists at the University of Regensburg conducted a randomized clinical trial involving 1,162 patients (average age 50) who had experienced chronic low-back pain for an average of eight years.

The patients were divided into three groups and all underwent 10 30-minute sessions (about two sessions a week) of treatment. One group of 387 patients underwent genuine traditional (verum) acupuncture. A second group of 387 received pretend (sham) acupuncture. The third group, 388 patients, underwent conventional therapy.

Verum acupuncture consisted of inserting needles to a depth of five to 40 mm, as in traditional Chinese medicine. In sham acupuncture, needles were inserted superficially, one to three mm into the lower back, avoiding all known acupuncture points or meridians but in an otherwise random fashion. Conventional therapy consisted of a combination of medication, physical therapy and exercise.

Remarkably, nearly 50 per cent of the patients in both the sham and verum acupuncture groups reported significantly decreased pain and improved functioning at six months as compared with roughly 25 per cent of the patients treated conventionally.

This is an impressive finding for acupuncture for what is a tough-to-treat condition; importantly, though, there was nearly no difference in the results for both the real and sham approaches.

HOW DOES IT WORK?

The benefit arises from one of two mechanisms. The first possibility is that randomly sticking sharp, thin needles into the back at either a very superficial depth or deeper into muscles or acupoints can somehow modulate the way in which humans process pain, and this provides relief.

BY Evra Taylor Levy and Eddy Lang

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