Overview of Low Back Pain and Acupuncture
Severe low back pain is a debilitating condition. Acupuncture has emerged as a promising first line treatment in uncomplicated cases, as it has less side effects. Indeed, acupuncture has more evidence for it in recent years and as a result is more popular than massage or chiropractor treatment or herbal therapy. Combined with physiotherapy and a short course of painkillers, acupuncture can be effective in dealing with non-specific back pain, although the pain relief seldom lasts for long. Pain injections like nucleoplasty and radiofrequency ablation are a good next step to consider.
Other treatments include exercises and medications such as NSAIDs, muscle relaxants and anti-depressants, which work on the affected nerves. Occasionally, opioids are not effective for long-term management of back pain. Side effects such as drowsiness, constipation, addiction and personality changes are also common. Non-specific low back pain rarely requires surgery, as there is usually not a significant improvement in symptoms, unlike surgery for pain that shoots down the leg.
What are the causes and risk factors of low back pain?
Causes of low back pain include:
- Injuries, trauma
- Degeneration
- Disc herniation and nerve impingement
- Autoimmune diseases
- Infections
- Cancer
- Carrying heavy loads at work
- Sports
- Surgery
- Obesity
- Smoking and alcohol
- Depression and stress
Risk factors include:
- Age between 40 to 70
- Women (related to the stresses and increased loading of pregnancy, menstruation, menopause and osteoporosis)
- Men (related to heavy physical work)
- Obesity
- Smoking
What is acupuncture?
Traditional Chinese Medicine Practitioners perform acupuncture. They place thin needles into the muscle, targeting the ‘meridians’ that handle various ailments. Other methods like moxibustion, electro acupuncture and acupressure also targets these meridians. There are few well-designed clinical studies to support its use, but patients across the world are very accepting of it because it is thought to be safe. Using alternative medicine modalities as these help complement healthcare in places around the world with limited access to modern medicine.
Yin and Yang and Qi
Traditional Chinese Medicine believes that pain results from the imbalance between Yin and Yang, between Qi, the essence of life, and Yang. Qi moves throughout the body in special conduits somewhat analogous to blood vessels which are known as meridians. When there is a blockage of the meridians, Qi is blocked. Illness results as there is an imbalance of Yin and Yang.
How does acupuncture help with Qi and Yin and Yang?
A theory of channels
There are 14 main meridians that run inside the body. Each meridian is made of an internal pathway passing through the various organs, and an external pathway which links to acupuncture points. Qi flows through these meridians which interconnect. Placement of acupuncture needles over the external pathway can unblock a ‘diseased’ meridian, allowing Qi to flow smoothly.
Does acupuncture work, or is it just placebo?
Trials show acupuncture works well in relieving chronic low back pain compared to not doing anything. Even though how acupuncture works is not known for sure, the results were so positive that even the insurances agreed to cover the cost of the treatments. Stimulating the sensory fibres appear to be one modality of action responsible for acupuncture’s effectiveness, besides the placebo effect that derives from the patient’s expectation.