Acupuncture for Back Pain
In May 2009, the National Institute for Health and Clinical Excellence (NICE) included a course of acupuncture treatment as one of the recommended ways of treating persistent, non-specific low back pain within the NHS. In China, acupuncture has been used as an effective treatment for back pain for thousands of years, and a growing number of people in the west are also able to testify to its effectiveness for easing their back pain; the decision by NICE to recommend acupuncture stems from the confirmation of acupuncture’s effectiveness by modern scientific research, some of which is referred to later in this article. However, effective treatment of back pain involves far more than just sticking a few needles in someone’s sore back.
Back Pain and TCM
Pain and restriction of movement arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of back pain, the obstruction is in one or more of the meridians (channels through which Qi flows around the body) on the back. So treatment will involve freeing up that flow of Qi, this will usually involve acupuncture treatment on the back and probably further down the meridians on the leg or foot; massage and cupping therapy may also help, as may a topical herbal application.
However, it is also important to understand why the Qi is getting stuck, and from the perspective of TCM there are several possible causes of this, including the following:.
i) Sometimes the Qi is blocked in the back due to what TCM calls a ‘pathogenic factor’ obstructing the flow; this is a form of external Qi which blocks the body’s own Qi. For example, if you are someone who feels the cold easily, and have been exposed to a cold environment, then a Cold pathogen may have entered the channels of the back and, as it were, ‘frozen’ the Qi there. The low back is particularly vulnerable to Cold pathogens, which leads to fairly severe pain which is worse in cold weather and better for a hot bath or hot water bottle. In this case as well as moving the Qi with acupuncture, we will want to expel the Cold, perhaps using moxibustion and warming topical applications. We will also, of course, advise you to keep yourself warm! Other common pathogenic factors are Damp and Heat; in the former case the back may feel heavy and perhaps be a little swollen, perhaps getting worse in wet weather; in the latter it may be warm and slightly red.
ii) Back pain may also point to underlying systemic disharmony. Our careful questioning at the initial consultation will give us a clear idea of any such disharmony, and in this case local treatment of the back will be supplemented by treatment to rebalance your Qi overall, using acupuncture and perhaps herbal therapy.
iii) Back pain which comes on suddenly, usually (but not always) as a result of an accident or trauma, should respond quickly to prompt treatment, but may suggest an underlying weakness in the back which needs longer term attention—this is especially the case if the injury occurs during normal activity.
Is Acupuncture Helpful in the treatment of Back Pain?
One of the trials on which the NICE recommendation mentioned above was based was a UK project 1 involving 241 patients with non-specific back pain, which showed that acupuncture was significantly more effective at reducing back pain than conventional NHS treatments.
A recent (2006) very large scale trial in Germany 2 involving over 1100 patients has found that acupuncture is much more effective at treating chronic low back pain than conventional therapies (drugs, physical therapy and exercise).
1 Thomas K. et al (2005) Longer Term Clinical and Economic Benefits of Offering Acupuncture Care to Patients with Chronic Low Back Pain Health Technol Assess 9(32) 1-128
2 Haake M. et al (2007) German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007 Sep 24;167(17):1892-8
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