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Can acupuncture help back pain?

Updated: Jan 8, 2022


acupuncture for back pain

I have written about acupuncture and pain but today's blog is going to specifically look at acupuncture for back pain. It is a condition we see frequently in acupuncture clinics, but I want to know about your back pain.....

  • what does your back pain feel like? Shooting pain that travels? Dull constant ache? Sharp twinges?

  • how long you have had your back pain?

  • what makes your back pain better or worse e.g. rest or exercise or heat etc

  • what caused your back pain?


Because I think the best question is can acupuncture help your back pain?


So today I am going to look at:

As always, if you have any questions or queries please do not hesitate to call me, or send me a message. I love to hear from you.


Love Andrea

 

Can acupuncture help back pain?

There is now huge swathes of evidence that acupuncture is beneficial for pain. Recently the National Institute of Centre of Excellence (NICE) published their updated findings on chronic pain treatments and they have recommended acupuncture as an option for the treatment of chronic pain.


Of course, chronic pain doesn't just refer to back pain. It can be considered as any pain in your body, and this will include, headaches/migraines as well.


Whilst acupuncture can help with a range of conditions, both physical and emotional, predominantly people tend to become patients, first, because of pain.


I am not saying I have a 100% success rate at treating back pain. There are lots of variables including of course structural issues e.g. herniated discs, but also other lifestyle factors that mean your back pain is not 100% rehabilitated.


But, what I can say is I am 100% committed to working with you to help either reduce or rid you of your pain.

  • the methods I use in treatment can be vast and effective for a number of different issues that I see. This might include electroacupuncture or gua sha or cupping therapy or of course needles.

  • I give you exercises to do, outside of your appointment, to help your pain

  • We use MYMOP, which allows us to evaluate at the start of each treatment how your pain levels have been between the treatments

  • I may, after discussion with you, refer you to another clinician who I think is better able to help you

  • There are also very little to no side effects to my treatments.

So let us look at the evidence of acupuncture for back pain.

 

The evidence of acupuncture for back pain


Acupuncture for chronic pain: update of an individual patient data meta-analysis

In what is considered one of the best acupuncture research studies undertaken, Vickers et al examined 20,827 patients over 39 trials for chronic pain.


Specifically, of those 39 trials 13 related to lower back pain. I have given a breakdown of those 13 trials below.


In their expert opinion, they said


Acupuncture is effective for the treatment of chronic musculosketal, headache and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain

Is acupuncture effective for back pain

It was interesting to do an overview of these 13 studies, which showed:

  • 14,621 patients were involved across the 13 studies

  • the number of treatments ranged from five to 20; the average number of treatments would be 9 with at least weekly sessions.

  • 12 out of the 13 studies indicated a positive outcome from receiving acupuncture for back pain

  • patients were still feeling the benefit of acupuncture for up to 1 year after the treatments

To see a full list of the research, you can take a look at the pictures below.


 

Acupuncture for sciatica

Sciatica is a pain that is felt in the:

  • bottom

  • back of your leg

  • feet and toes

This sensation may be:

  • painful: stabbing, burning or shooting

  • tingling like pins and needles

  • numb or weak

Your symptoms may be worse for movement and whilst you may have back pain, it is not normally the primary pain.



Acupuncture for sciatica: the evidence

In a 2015 systematic review, they highlighted 12 studies totalling 1842 patients who had sciatica.


They found:

  • acupuncture was significantly more effective than conventional medication

  • only three studies discussed pain intensity, but of those three they found that the acupuncture group experienced a significantly greater reduction in pain intensity than those who received conventional medication

  • acupuncture increased pain threshold favourably compared with medication

  • two people (out of 1842) experienced a side effect, which was a subcutaneous haemorrhage


 

Red flags of back pain

As well as being an acupuncturist we are also required to learn about biomedicine, medication (and their side effects) and also red flags of signs and symptoms. I wrote a very comprehensive blog about the urgent referral red flags here.


For back pain, high priority referrals are:

  • sudden onset of low back pain that is so severe that walking is impossible (severe sciatica). Whilst sciatica is not an absolute indication for referral, if there is difficulty in urinating or defecating or if the condition is progressive or not responding to treatment

  • pubic symphysis pain in pregnancy

  • persistent loin pain (between levels of T11 and L3


 

Acupuncture for back pain in pregnancy


Acupuncture for back pain in pregnancy

During my research for this blog post, I came across lots of interesting research and information on acupuncture for back pain in pregnancy.


Back pain in pregnancy can often be a common and very uncomfortable feeling that without being able to take pain medication for, you may just have to live with it for the duration of your pregnancy.





Debra Betts is a world-renowned acupuncture practitioner who has become synonymous with women's health and in particular pregnancy. In a 2018 observational study, she co-authored, 88.9% of the patients treated found

clinically meaningful symptom reduction

in lumbopelvic pain when using acupuncture.


To hear more about Debra Betts you can listen to a podcast she did on the treatment of back pain in pregnancy with acupuncture.


Acupuncture for pelvic and back pain in pregnancy

Cochrane, which is considered the gold standard of evidence-based research, published a report in 2013 called "Interventions for preventing and treating pelvic and back pain in pregnancy (Review)".


In this review, which included 26 randomised control trials (RCTs) with 4093 women, they found:


Moderate-quality evidence showed that acupuncture or exercise, tailored to the stage of pregnancy, significantly reduced evening pelvic or lumbo-pelvic pain
 

Is it safe to get acupuncture for back pain in pregnancy?

If you see a registered, trained (3-year degree level training) and regulated acupuncturist we are taught how to treat safely. We are taught correct needle methods and depths and we are also very aware of any acupuncture points and methods which would be contraindicated in pregnancy.


I am not saying that side effects do not occur, see this blog post I wrote here, but that there is very little chance of serious adverse events.


Adverse event reporting in studies of penetrating acupuncture during pregnancy: a systematic review

In a 2015 systematic review by Clarkson et al, they found that 17 studies of acupuncture in pregnancy.


A total of 2,219 patients received acupuncture for a number of different symptoms including:

  • nausea

  • lower back pain

  • insomnia

  • pelvic girdle pain

  • depression

  • emotional complaints

Of those 2,219 patients who received treatment with acupuncture, 31 adverse events occurred. The non-serious side effects were:

  1. altered taste

  2. bleed at the needle site

  3. bruising

  4. deqi (this is the sensation that is experienced and wanted by acupuncturists; read more about it here or scroll down below)

  5. fainting

  6. haematoma

  7. headache

  8. heaviness of arms

  9. increased energy

  10. intense emotional release

  11. localised anaesthesia

  12. localised pain

  13. nausea

  14. needle pain/discomfort

  15. painful uterine contractions

  16. placed on bed rest

  17. pressure in nose

  18. rash

  19. sadness

  20. sense of wellbeing

  21. shooting pain down the leg

  22. sleep disturbance

  23. sleepiness/drowsiness

  24. sweating

  25. tattooing of skin

  26. thirst

  27. the transient feeling of drop in blood pressure

  28. unpleasant treatment

  29. weakness

  30. worsening of complaint




One serious unexpected adverse event did occur in one of the treatments. In a retrospective study in 2001 for lower back and pelvic pain in pregnancy one lady went into premature labour at week 15. The treatment was immediately ended and the labour spontaneously stopped after 24 hours. This person then went on to have a normal and healthy pregnancy, delivering at 42 weeks.


Obviously, this is a serious adverse event and thankfully the pregnant person went on to have a full-term pregnancy.

In my treatments, I will take a cautious approach to pregnancy and in my initial consultation, we discuss any red flags. See below for any symptoms that need to be flagged.



Acupuncture for pregnancy.  What are the red flags in pregnancy?


 

Who else can help your back pain?

There are so many people you might see for your back pain. It could be:

  • an acupuncturist: Acupuncture is one of the longest established forms of healthcare in the world. Acupuncturists are trained to use subtle diagnostic techniques and the focus is on you as an individual. Acupuncture enjoys a high level of evidence for a variety of conditions. This includes mental-emotional and physical conditions.

  • an osteopath: Patients seek treatment for a wide variety of conditions, including back pain, changes to posture in pregnancy, postural problems caused by driving or work strain, the pain of arthritis and minor sports injuries.

  • a chiropractor: Chiropractic treatment involves safe, often gentle, specific spinal manipulation to free joints in the spine or other areas of the body that are not moving properly.

  • a physiotherapist: Physiotherapy helps restore movement and function when someone is affected by injury, illness or disability.

  • a sports massage therapist: Sports massage is a form of massage involving the manipulation of soft tissue to benefit a person engaged in regular physical activity.

  • or even your doctor: treat all common medical conditions and refer patients to hospitals and other medical services for urgent and specialist treatment.

Who you choose to see is a matter entirely of preference. All of these practices are aligned with what you might need for back pain.


The one thing I always say is that osteopath's, physiotherapists, sports masseurs and chiropractors (and even GPs) are all known to use acupuncture techniques....but VERY often without the same level of training as an acupuncturist.


And they use it because it works!



 

Acupressure and qigong for back pain: to try at home

As always, with most of my blogs, I try and give you practice that you can do at home.


Acupressure

  • Yaotongxue is two points that can be held whilst also gently circling the pelvis. When you have located the points (and you can choose your left or right hand) you circle your waist gently 12 times. Then circle the other way for a count of 12 whilst deep breathing

  • Small intestine 3 is a point on the side of your hand. Again you can use either hand, and you press and knead the point for 30-60 seconds till it feels tender and warm



Qigong

  • Peter Deadman is an esteemed acupuncturist and qigong master. Here is a video he made for the lower back part 1

  • Qigong with Kseny has a 20 minute Qigong for Lower Back & Spine - Qigong Back Pain Relief

If you are local to me in Hertfordshire I can also recommend qigong practise, in person, with either:


What muscle?

I have just been listening to the Rich Hazel podcast "The Acupuncture Outsider" where he gives some really brilliant advice around muscles involved in back pain.


I have summarised his points and given additional resources that you can do at home if you are suffering from back pain. Which muscle do you think is involved in your back pain?



Gluteus medius:

  • pain is when bending forward

  • when you get up in the morning and you feel stiff

You can foam roll the area or use a tennis ball to find the sore points. Using a tennis ball start working out the knots. This self-treatment can be done anywhere where you can lean against a wall with a tennis ball.


Quadratus lumborum:

  • may hurt to cough or sneeze

  • usually injured when bending forward in the rotation

  • back pain when just standing or when carrying something in one arm

  • pain may be when going upstairs

  • could have functional leg length discrepancy

  • sharp shooting pain

  • hard to turn over in bed

Stand with a tennis ball pressed against the wall just below your lowest rib and lean in putting pressure on the sore spots starting at the top and working your way down toward the pelvis. Allow pressure to do its job. A minute or two at a time is enough. Short periods of work done more frequently will probably work best. Some heat before working with the ball will also help


Spinal erectors:

  • pain is when you come up from bending down

  • longissimus is most common but palpate


self-massage: here are two useful videos:



PSOAS:

  • do not needle unless very competent (inguinal ligament)

  • side sleepers

  • if they want to sleep on their back they need a bolster under their knees

  • if no support then the back pain will be felt

  • sharp pain on standing up, after sitting

  • cannot lift knee up (when standing) to put on shoe

Stretches for PSOAS lengthening e.g. stand straight up and put hands on hips and look up to the ceiling. You want to breathe into your diaphragm (PSOAS and diaphragm are very interlinked)



Multifidus:

  • sharp pain in the disc area

  • palptation is key

heat first and stretch (cat/cow)

try and relax and breath

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