TORONTO — Acupuncture — even simulated acupuncture using toothpicks pushed against the skin — appears to relieve symptoms of chronic low back pain better than standard medical treatment, a large patient trial has found.
But investigators in the SPINE (Stimulating Points to Investigate Needling Efficacy) trial say they aren’t sure how the ancient practice of using needles on certain points of the body actually works.
The study found that 60 per cent of participants who received any one of three types of acupuncture during seven weeks of treatment had improved function, compared to 39 per cent of those who received standard care.
“Compared with usual care, individualized acupuncture, standardized acupuncture and simulated acupuncture had beneficial and persisting effects on chronic back pain,” write the authors, whose work is published Tuesday in the Archives of Internal Medicine.
The study involved 683 adults aged 18 to 70 with chronic lower back pain, none of whom had ever before had acupuncture. Participants were randomly assigned to receive one of three acupuncture treatments or standard medical care.
One group had needles inserted under the skin in a pattern tailored to their particular back pain by a diagnostic acupuncturist; the second group got a standardized arrangement of inserted needles for the condition; a third group received simulated acupuncture, in which toothpicks were pressed against acupuncture points without going through the skin.
Those in the non-acupuncture group were left to choose their own treatment, which could have involved a doctor’s visit, chiropractic treatment or massage. Most people in this group took some kind of anti-inflammatory painkiller, such as ibuprofen.
Patients in the three acupuncture groups were treated twice a week for three weeks, then weekly for four weeks. At eight weeks, six months and one year, researchers measured back-related dysfunction and how much symptoms bothered patients in all four groups.
“What we found is that those who had one of the acupuncture or simulated acupuncture treatments actually were able to do three more ... daily activities” following the treatment course than participants assigned to regular care, principal researcher Dan Cherkin said Monday from Seattle.
A followup at one year after enrolment showed 59 per cent to 65 per cent of those in the acupuncture groups were still experiencing improvement, compared with 50 per cent of those in the usual-care group.
“Acupuncture appears to be an effective treatment for chronic back pain,” said Cherkin, a senior investigator with the Group Health Center for Health Studies in Seattle.