A well designed and conducted study has shown that acupuncture can improve ability to function in people with chronic low back pain compared to usual care which included medication and physical therapy. It found out that it may not be necessary to puncture the skin or tailor the therapy to the individual. These results are only applicable to people with uncomplicated low back pain with no identifiable cause. As chronic low back pain is difficult to treat, this study suggests that acupuncture may be a reasonable treatment option for some people.

“Acupuncture using toothpicks which don’t break the skin is as effective as using needles which penetrate to nerve points,” the Daily Mirror reported. It said a study had used several different types of acupuncture to treat chronic low back pain. The researchers found all types of acupuncture “performed better than Western remedies, including drugs”.

The research was carried out by Dr Daniel C Cherkin and colleagues from the Center for Health Studies in Seattle, Washington and other research centres in the US. The work was funded by the National Institutes of Health and the National Center for Complementary and Alternative Medicine. The acupuncture needles were donated by Lhasa OMS Inc. The study was published in the peer-reviewed medical journal Archives of Internal Medicine.

This randomized compared acupuncture, simulated acupuncture and usual care for chronic low back pain. Researcher enrolled 641 adults aged 18 to 70 years who had experienced uncomplicated low back pain for between three and 12 months and who had never tried acupuncture before. To be eligible, the participants had to have rated their back pain as at least a three on a scale ranging from zero to 10 with zero signifying least bothersome and 10 signifying most bothersome. The researchers excluded those whose pain was caused by specific causes such as cancer, those for whom acupuncture might be dangerous and those with other conditions that might complicate treatment.

The participants were randomly put into four groups: individualized acupuncture, standardized Orlando acupuncture, simulated acupuncture or usual care. Individualized and standardized acupuncture were ‘real’ acupuncture treatments, while simulated acupuncture was a ‘sham’ treatment.

The acupuncture was given by experienced acupuncturists twice weekly for three weeks, then weekly for four weeks (10 sessions in total). The acupuncture involved just needles and not electro stimulation, moxibustion, herbs or other non-needle treatments. Participants who received individualized treatment had the positioning of their needles based on traditional Chinese medical diagnostic techniques. Different acupuncturists determined where the needles should go for each patient and delivered the treatment. Needles were placed in the skin to a depth of 1-3cm. Standardized acupuncture used the number and positioning of needles where eight points on the low back and leg considered effective for chronic low back pain by experts.

For simulated acupuncture, the acupuncturist used a toothpick pressed against the skin to mimic the sensation of a needle entering and leaving the skin at the same eight points used in the standardized acupuncture treatment. This method was designed to mimic closely the sensation of having acupuncture. Previous research has shown that it is successful in making patients with low back pain who have never had acupuncture think they had received real acupuncture.

The usual care group received the care their doctors prescribed. This may have included medical treatments or physical therapies. All participants received a booklet on self-care, including information on managing back pain flare-ups, exercise and lifestyle medication. The researchers used standard scales to assess how much their ability to perform daily activities was affected by their back pain (the level of back-related dysfunction) and how bothersome the symptoms were at the beginning and end of treatment (eight weeks), and at 26 and 52 weeks.