In the United States, 80% of people experience back pain at some point in their lives. (NIH, 2019) The majority of cases are acute and caused by accidents, wrong movements, or lifting something heavy. In some cases, pain develops over time due to age and lifestyle. About 20% of all cases turn chronic and last for 12 weeks or more.
Back pain doesn’t just impact health either. Healthcare spending is 2.5 times high for those adults with back pain, with annual spending of $1,440. Further, those who’s pain limits their ability to work earn 2/3rds less than those who don’t suffer from back pain. (Georgetown, 2019)
Causes
The majority of back pain cases are mechanical in nature, having to do with the physical structure and positioning of the back. (NIH, 2019)
- This can be muscle or tendon strain, or ligament sprain caused by overstretching or lifting something too heavy.
- It can also be related to intervertebral discs in the form of degeneration, which often develops as we age, or compression of the discs causing herniation or rupture.
- Nerve root compression, causing numbness, pain, or tingling that travels to other parts of the body, is very common. One well-known example of this is sciatic nerve pain.
- Misalignment of the vertebra (spondylolisthesis) or pelvic girdle (Sacral Iliac joint pain) can be a cause of back pain. Abnormal curvature, such as scoliosis or lordosis, can also be a cause of pain.
- Arthritis, which the majority of people develop at some point in their lives, causes pain when the degeneration of joints causes bone on bone friction.
- Osteoporosis, which is a decrease in bone density that is more common in postmenopausal women, can lead to painful fractures of the vertebrae.
- Spinal Stenosis, which is a narrowing of the spinal canal, can put pressure on the spinal cord and can cause pain, numbness, and weakness over time.
Chronic conditions that predispose people to back pain include:
- Inflammatory Joint diseases, such as rheumatoid arthritis (RA), Spondyloarthritis (Spondylitis).
- Fibromyalgia is a chronic pain syndrome that presents with widespread body pain, fatigue, and often depression.
Other rare causes of back pain can include infection, Cauda Equina Syndrome, Abdominal Aortic Aneurysms (AAA), Kidney stones, Endometriosis, etc. Such cases should be evaluated by healthcare professionals.
Can Acupuncture Help Back Pain?
The benefit of acupuncture in treating back pain is a hotly debated subject today, with the biggest obstacle of a final judgment being the difficulty in putting together controlled medical trials. However, studies do indicate that acupuncture provided by a well-trained practitioner results in some positive effect on most people (Bauer, 2019), making it a reasonable referral option.
An international team of experts pooled the results of 29 studies involving approximately 18,000 participants found that, overall, acupuncture relieved pain by about 50%. (Vickers, 2012)
Another study based on 7 systematic reviews found that “acupuncture is more clinically effective in pain relief and functional improvement than no treatment at short-term follow-up.” (Liu, 2015) This study goes on to state that acupuncture also “provides short-term clinically relevant improvements in pain and functional measures for the treatment of chronic low back pain.”
Dr. Lucy Chen, a Harvard-affiliate Massachusetts General Hospital physician, states “the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication.” (Pendick, 2013)
Ultimately, acupuncture is becoming more accepted by mainstream medicine as a complementary therapy because it gets results for a significant percentage of people. With the low risk of side-effects, Acupuncture is a worthwhile therapy in the treatment of back pain.
Treatment
Treatment can vary greatly depending on duration and severity, and ranges from home care to surgery. As a general rule, the longer-term and more severe the pain, the more treatment will be needed to see the best results. On the opposite end of the spectrum, acute injuries for fewer days should only require a few visits.
So, if you hurt your back moving something heavy or while over-exerting yourself while exercising, then you would most likely need a few treatments in quick succession.
On the other hand, if you have had back pain that’s been getting worse over the past year (or more), and it has now reached the point of unbearable pain, then your course of treatment might be a bit longer. A standard treatment plan being 2x/week for 4-6 weeks, with follow-ups at a reduced frequency until the pain subsides.
What that really means is, the sooner you come in, the sooner you will be out of pain and on the road to long-term prevention.
Frequently, acupuncture is done in conjunction with conventional therapy. It is helpful to have a medical diagnosis in severe cases, particularly to rule out anything more serious. If you want to learn more about conventional treatment, the NIH has an excellent article here.
How it Works
While the efficacy of acupuncture is the focus of most medical studies, how it actually affects the body is not well understood. There are, however, several mechanisms of action consistent with science that are thought to play a role:
- Nervous System Stimulation – causes the body to release chemicals & hormones that are naturally pain relieving, and speed recovery.
- Stimulates the Body’s Natural Healing Functions – by creating micro-tears near sites of injury, the body can respond to injuries with greater application of resources to rebuild tissues and increase blood flow.
- Muscle Chain Interaction – Most muscles are part of what is commonly referred to as a “muscle chain,” meaning that they are part of a group of muscles that work together. By stimulating different points on such a chain, acupuncture can impact pain from a different aspect of the body.
In the language of Chinese Medicine, an acupuncturist will define the cause of pain. Typically, this will be “Qi Stagnation” or “Blood Stasis,” which really just means that the body’s natural resources are inhibited in the area of pain. Using the ultra-thin acupuncture needles, the acupuncturist will then choose the points to open the impeded area and increase blood circulation so new resources can be brought in and the area can heal.
Herbal Therapy
In some cases, herbal therapy is used along with acupuncture for back pain. When adding in herbs for such cases, the root cause determines what goal we have.
For pain and inflammation, a Curcuma based supplement can be very effective. Patients can take it as a stand-alone supplement, or as part of a Chinese Herbal Formula. The Golden Flower brand we use in our office is called “Curcuma Longa” known as Jiang Huang Wan in Traditional Chinese Medicine.
In other cases, muscle spasms need to be addressed before healing can begin, in which case we often use a formula called “Corydalis formula” (Shao Yao Gan Cao Jia Yan Hu Tang) produced by Golden Flower.
And, for arthritis, we often use a formula known as “Drynaria 12” which is produced by Seven Forests herbal company. It’s one of the few formulas we prescribe long term because it can slow the progression of degenerative arthritis significantly over the long term.
Prevention
As always, the best thing you can do for yourself is preventative. Start early to keep your back healthy if you can, or slowly implement exercises to strengthen your core muscles over time. Some basic things to keep in mind:
- Stretching before physical activity goes a long way, and so does adding a 10-minute stretch routine to your morning.
- Do your best to maintain good posture to reduce stress on your back. Use lumbar support, keep your shoulders back, and work with surfaces that are at a comfortable height.
- Alternate between sitting and standing. Aim to give your body a break by switching to the opposite position every 40 minutes or so, even if the switch is only for 5-10 minutes.
- When lifting heavy objects, lift from your knees and do not twist while lifting. It also helps to keep said object close to your body. And, whenever possible, have someone else help you.
- Proper nutrition and fitness levels make a huge long-term difference.
Finally, very importantly, take small injuries seriously. Preventing chronic conditions means letting acute ones fully heal as quickly as possible. In most instances, acupuncture in the first few days will have a long-term impact.
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Sources:
Bauer, M.D., & Mayo Clinic. (2019, April 23). What to know about acupuncture for back pain. Retrieved from https://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/acupuncture-for-back-pain/faq-20058329
Georgetown University Health Policy Institute. (n.d.). Chronic Back Pain. Retrieved August 3, 2019, from https://hpi.georgetown.edu/backpain/
Liu, L., Skinner, M., Mcdonough, S., Mabire, L., & Baxter, G. D. (2015). Acupuncture for Low Back Pain: An Overview of Systematic Reviews. Evidence-Based Complementary and Alternative Medicine,1-18. doi:10.1155/2015/328196
NIH (National Institutes of Health), & National Institute of Neurological Disorders and Stroke. (2019, May 14). Low Back Pain Fact Sheet. Retrieved August 3, 2019, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
Pendick, D., & Harvard Health Publishing. (2013, April 01). Acupuncture is worth a try for chronic pain. Retrieved from https://www.health.harvard.edu/blog/acupuncture-is-worth-a-try-for-chronic-pain-201304016042
Vickers, DPhil, A. J., Cronin, MS, A. M., & Maschino, BS, A. C. (2012). Acupuncture for Chronic Pain Individual Patient Data Meta-analysis. JAMA Internal Medicine. Retrieved August 3, 2019, from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1357513.
White, A. (2019, February 26). Acupuncture for Back Pain: Does it Work? (D. Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Ed.). Retrieved August 3, 2019, from https://www.healthline.com/health/acupuncture-for-back-pain#research
