Acupuncture is an effective treatment for relief from low back pain, even when compared with other interventions (sham acupuncture, usual care, or no treatment), with stronger effects observed immediately after treatment. Clinically significant reduction in pain is more reliably observed in chronic rather than acute low back pain (strength of recommendation: A, based on systematic review and meta-analysis of randomized controlled trials [RCTs]).
The American College of Physicians issued a clinical
practice guideline recommending acupuncture as a first-line therapy for acute
and chronic nonradicular low back pain along with other nondrug therapy
including stretching, heat application, massage, and manual spinal
manipulation.5 The
National Institutes of Health’s National Center for Complementary and
Integrative Health considers acupuncture to be a safe treatment when done by trained
acupuncturists using sterile needles.
Research evidence from systematic reviews
Systematic review and meta-analysis involved in 6656
participants comparing acupuncture with other treatments (sham acupuncture, no
treatment, transcutaneous electrical nerve stimulation, medications, usual
care) found that acupuncture was clinically superior to sham acupuncture in
pain reduction for patients with chronic low back pain (CLBP) immediately after
and up to 3 months following treatment. Further, acupuncture provided more pain
relief in CLBP compared with no treatment and usual care, which typically
consisted of nonacupuncture care like physical therapy, massage, and medication.
Systematic reviews involved in 11 682 participants comparing
acupuncture with sham acupuncture, no treatment, or acupuncture plus
conventional treatment, which included physical therapy, exercise, and
medication, revealed inconsistent evidence of benefit in acute low back pain. Acupuncture
was consistently found to provide superior pain relief for CLBP lasting greater
than 3 months in the short term.
Systematic reviews involved in 7958 participants analysed
acupuncture versus sham acupuncture for chronic low back pain and found that
acupuncture significantly reduced pain intensity immediately and 12 weeks after
treatment. Compared with medications (nonsteroidal anti-inflammatory drugs,
muscle relaxants, or analgesics), acupuncture provided greater pain relief and
improved function.
Neuroimaging Studies of Acupuncture on Low Back Pain suggested
that improving abnormal structure and functional activities in the brain of the
LBP patient is an important mechanism of acupuncture treatment for LBP. The
brain regions involved in acupuncture analgesia for LBP were mainly located in
the pain matrix, default mode network (DMN), salience network (SN), and
descending pain modulatory system (DPMS).
References
Roselyn Clemente Fuentes et al Can Fam Physician. 2020
Mar; 66(3): 186–187.
Qiao Wen et al Front Neurosci. 2021; 15: 730322.
