Back pain is a common condition which affects more than 1 million people in the UK. Back pain can be caused by many factors. But some of the causes cannot be found.
95% of back pain occurs in the lower back. It is defined as non-specific low back pain. Non specific low back pain is tension, soreness and stiffness in the lower back region and the specific cause of the pain cannot be identified. The pain is normally as lasted for more than 6 weeks, but less than 12 months. The pain is persistent or recurrent. Joints, discs and connective tissues in the back may contribute to symptoms. Low back pain affects more than 79% of the population in developed countries. It accounts for 13% absences due to illness in the UK. 35-55 year old are affected most. 90% of the episodes of acute low back pain settle within six weeks, up to 7% of patients develop chronic pain. A study from a study with 5000 adults by the British Acupuncture Council to mark 'Acupuncture Awareness Week' (3rd-10th March 2014) show that almost 80 per cent of people suffer with back pain admit to behaviours that put their backs under unnecessary strain. This study found that almost half of the adults admit to eating on their lap, 40 per cent complain they sit at a desk all day and over a third admit to watching TV or films in bed. When asked about their posture, almost a third also admitted they slouch most of the time.
In the case of treatments for back pain, 74 per cent say they repeatedly use painkillers to deal with their discomfort, which would numb the end symptom and mask the problem but do not address many of the combined underlying causes of back pain rather than addressing the root cause of the problem. Statistics show that 41 per cent of people would only consider acupuncture as a last resort and 88 per cent didn't know the National Institute of Clinical Excellence (NICE) recommends acupuncture therapy for persistent, non-specific lower back pain.
Some patients do turn to complementary and alternative medicine for back pain treatments. What do these patients expect from CAM treatments?
There was a study with semi-structured interviews with 64 individuals receiving massage, chiropractic, acupuncture or yoga for chronic low back pain. The findings included that participants' expectations of treatment outcomes were in four key aspects: pain relief, improved function (including an increase in ability to engage in meaningful activities), improved physical fitness, and improved overall well-being (including mental well-being). Typically, patients had modest expectations for outcomes from treatment.
With 2.3 million acupuncture treatments carried out each year, acupuncture is one of the most popular complementary therapies practised in the UK today. By stimulating different points of the body, acupuncture can be extremely beneficial for back pain, providing long term pain relief and reducing inflammation.
Low back pain with acupuncture treatment
Acupuncture is well known for its effectiveness for back pain. Many research data have provided solid evidence that acupuncture is effective for lower back pain.
NHS recommended acupuncture combined with self-care for persistent low back pain.
Acupuncture alone is effective to relieve back pain. Also acupuncture can be one of the combined treatments offered to patients which reduce the use of medications and improve the outcome. Self care and acupuncture can help release low back pain. This is recommended by NICE guidance as treatment options for persistent low back pain. Cheshire A et al reported their survey based in a primary and community care setting, delivering acupuncture, self management and information to patients with chronic low back pain. They evaluated patient outcomes and experiences of the Beating Back Pain Service (BBPS). The questionnaire is at three time points: pre-BBPS, immediately post-BBPS and three months post-BBPS. There were 80 participants with mean age 47 years. 65% of them were female. Their results showed that pain scores were improved between baseline and post treatment, these improvements were maintained at 3 months follow-up. Patients receiving a combination of acupuncture and self-management sessions produced the most positive results. Patients satisfaction with the BBPS was high. They concluded that combining self-management with acupuncture was most effective, though further consideration is needed to engage patients in self-management. Acupuncture has no severe side effects which can be applied over a longer period of time. The National Institute for Heath and Clinical Excellence guidelines on best practice now recommend offering a course of 10 sessions of acupuncture as a first line treatment for persistent, non specific low back pain.
Mechanisms of acupuncture for low back pain
Acupuncture needles are used to treat low back pain. The mechanism of this treatment is still not clear. Why some people respond well while others do not. A study examined changes in lumbar multifidus (LM) muscle function and nociceptive sensitivity after dry needling in patients with LBP and to determine if such changes differ in patients that exhibit improved disability (responders) and those that do not (non-responders). Sixty-six volunteers with mechanical LBP completed the study. Ultrasound measurements and pain algometry of the LM were taken at baseline and repeated immediately following dry needling treatment to the LM muscles and after one week. The percent change in muscle thickness from rest to contraction was calculated for each time point to represent muscle function. Pressure pain threshold (PPT) was used to measure nociceptive sensitivity. Participants were divided into responders and non-responders based on whether or not they experienced clinical improvement using the modified Oswestry Disability Index after one week. Patient responders showed larger improvements in LM muscle contraction and nociceptive sensitivity 1 week, but not immediately, after the treatment than non-responders. The results suggest that there may be lasting and clinically relevant sensorimotor changes that occur in LBP patients that improve with acupuncture needle treatment
References
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