Acupuncture effective for lower back pain
Yuan J et al. Effectiveness of acupuncture for low back pain: a systematic review.
Spine 2008; 33(23): E887-900.
Systematic review and meta-analysis of 23 trials involving 6,359 patients, which looked at acupuncture in the treatment of low back pain. It found moderate evidence that acupuncture is more effective than no treatment and strong evidence that acupuncture is a useful supplement to other forms of conventional therapy. The reviewers concluded that acupuncture should be advocated for the treatment of chronic low back pain.
Management of acupuncture in chronic low back pain
Ammendolia C, Furlan AD, Imamura M, Irvin E, van Tulder M. Evidence-informed management of chronic low back pain with needle acupuncture.
Spine J. 2008 Jan-Feb;8(1):160-72.
Review article on management of chronic LBP with acupuncture. Explains theories of acupuncture’ mechanisms of action on pain and reviews evidence of its efficacy. Cites evidence that, compared with no treatment, acupuncture is effective in pain relief and functional improvement immediately after treatment and in short-term follow-up. Also that acupuncture is as effective for pain relief and functional improvement as conventional treatments. Concludes that the most consistent evidence is for the addition of acupuncture to other therapies, which demonstrated more effect in pain relief and functional improvement than the same therapies without acupuncture
Acupuncture can help relieve back pain and sciatica by:
- stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Pomeranz 1987, Zhao 2008)
- reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003)
- improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling
- causing a transient change in sciatic nerve blood flow, including circulation to the cauda equine and nerve root. This response is eliminated or attenuated by administration of atropine, indicating that it occurs mainly via cholinergic nerves (Inoue 2008)
- influencing the neurotrophic factor signalling system, which is important in neuropathic pain (Dong 2006)
- increasing levels of serotonin and noradrenaline, which can help reduce pain and speed nerve repair (Wang 2005)
- improving the conductive parameters of the sciatic nerve (Zhang 2005)
- promoting regeneration of the sciatic nerve (La 2005).