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Acupuncture Shown to Work Better for Lower Back Pain

People suffering from chronic low back pain who received acupuncture
or simulated acupuncture treatments fared better than those receiving
only conventional care According to a recent study published in the
Archives of Internal Medicine. The study highlights central questions about the mechanisms of benefit seen in acupuncture studies.

This trial, led by Daniel Cherkin, Ph.D., of Group Health Center for
Health Studies in Seattle, was funded by the National Center for
Complementary and Alternative Medicine (NCCAM), a component of the
National Institutes of Health.

"Because of the lack of highly effective medical treatments for
chronic low back pain, we were pleased to find that acupuncture-like
treatments were helpful for persons suffering from chronic back pain,"
said Dr. Cherkin. “However, the finding that real acupuncture produced
no greater benefit than simulated acupuncture raises important
questions about acupuncture’s mechanisms of action."

This trial enrolled 638 adults with chronic low back pain who had
never had acupuncture and who had rated the "bothersomeness" of their
pain as at least a 3 on a 0-to-10 scale. The participants were randomly
assigned to one of four groups: individualized acupuncture, involving a
customized prescription for acupuncture points from a diagnostician;
standardized acupuncture, using a single prescription for acupuncture
points that experts consider generally effective for chronic low back
pain; simulated acupuncture, which mimics needle acupuncture but does
not involve actual penetration of the skin; or usual care, which is
standard medical care.

The patients assigned to any of the three acupuncture groups
(individualized, standardized, or simulated) were treated twice weekly
for three weeks, and then weekly for four weeks. At 8, 26, and 52
weeks, researchers measured back-related dysfunction and how much
symptoms bothered participants.

The researchers found that at eight weeks the individualized,
standardized, and simulated acupuncture groups all improved their
dysfunction scores significantly more than the group receiving usual
care. These benefits persisted for one year, though diminished over
time. However, there was no significant difference between the groups
receiving the needle and simulated forms of acupuncture. Thus, while
acupuncture was found effective in treating low back pain, neither
tailoring acupuncture needle sites to an individual patient nor
penetrating the skin appears to be important for receiving therapeutic

"The findings of this research show that acupuncture-like
treatments, including simulated acupuncture, can elicit positive
responses," said Josephine P. Briggs, M.D., director of NCCAM. "This
adds to the growing body of evidence that there is something meaningful
taking place during acupuncture treatments outside of actual needling.
Future research is needed to delve deeper into what is evoking these

The researchers believe that further research is needed to determine
the roles of patient expectancy, practitioner reassurance and the
physiological effects of non-insertive stimulation and other effects
that may contribute to acupuncture-like benefits.

The National Center for Complementary and Alternative Medicine’s
mission is to explore complementary and alternative medical practices
in the context of rigorous science, train CAM researchers, and
disseminate authoritative information to the public and professionals.
For additional information, call NCCAM’s Clearinghouse toll free at
1-888-644-6226, or visit the NCCAM Web site at NCCAM
1999–2009: Celebrating 10 years of rigorous research


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