Low back pain is second only to the common cold as a cause of lost days at work and is one of the most common reasons. Although most low back pain is nonspecific and selflimiting, a subset of patients develop. Acupuncture has been studied for a wide range of pain conditions, such as postoperative dental pain, carpal tunnel syndrome, fibromyalgia, headache, lowback pain, menstrual. One hundred and fifty outpatients with chronic low back pain. Considering how challenging it is to translate research into practice, the value of. Acupuncture for treatment of chronic lowback pain caused. In addition to the divergence of results, there is no yamamot among authors regarding the choice of acupuncture points and treatment methods systemic acupuncture, auricular acupuncture, electroacupunture, among others. Acupuncture for chronic low back pain in routine care article in clinical journal of pain 232. The centers for medicare and medicaid cms will cover acupuncture for chronic low back pain. It also entails enormous social and economic costs. However, the question remains whether individualized acupuncture, which needs more. National coverage determination ncd for acupuncture for. It is often difficult to treat nerve pain with traditional medications as nerve pain does not respond well to prescription pain relievers, including narcotics.
A singlecenter randomized controlled singleblind trial was performed in a general medical practice in germany run by a chineseborn medical doctor trained in western and chinese medicine. Acupuncture achieved better outcomes when compared with other treatments. Using the incremental costeffectiveness ratio icer, i. Back pain can affect anyone at any age and most people will suffer from it at some point in their lives. Varying structures can contribute to these symptoms, including the joints, discs and connective tissues. Acupuncture for chronic low back pain clinical therapeutics, n engl j med 2010. Acupuncture is one of the most frequently sought complementary and alternative medicine modalities for treating low back pain. Acupuncture may sound like an exoticmaybe even improbabletreatment for chronic pain. The committee recommended that studies be conducted on the efficacy of acupuncture in the treatment of pain for 3 diseases, including chronic low back pain. Internal validity and external validity of systematic.
Effects of myofascial release in nonspecific chronic low. Backache alternative treatment acupuncture clinical trials. Acupuncture for treatment of chronic lowback pain caused by lumbar spinal stenosis. Chronic low back pain is a costly medical complaint in canada and other industrialized nations. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Trigger point, low back pain, elderly, randomised controlled trial. It can cause many physical, mental, and emotional problems on the victim mendelson, selwood, kranz, loh, kidson, scott, 1983. Acupuncture is increasingly being recognized by western medicine as an effective alternative or adjunct to conventional treatments for a long list of conditions including headache, menstrual cramps, joint pain, low back pain, and asthma, as well as for the side effects of chemotherapy and nausea related to pregnancy. Unitedhealthcare medicare advantage policy guideline. A 45yearold man with a 7year history of low back pain asks his physician for a referral to a licensed acupuncturist. Cleveland acupuncture for sciatica, arthritis, low back pain. However, 25% or more of patients have recurrent pain within the next year,4 and chronic low back pain develops in up to 7% of patients. Acupuncture treatment of chronic low back pain was studied in a placebocontrolled doubleblind crossover trial completed by 77 patients.
Acupuncture is an effective treatment for chronic low back pain, but this effect is likely to be produced by the nonspecific effects of manipulation. Acupuncture has been studied for a wide range of pain conditions, such as postoperative dental pain, carpal tunnel syndrome, fibromyalgia, headache, low back pain, menstrual. It is the uks leading cause of disability and one of the main reasons for workrelated sickness absence. The acupuncture randomized trial in low back pain was part of a larger acupuncture project initiated by the german federal committee of physicians and health insurers. The start back screening tool sbst although promising, has not been studied in patients with chronic low back pain clbp. In most cases,the specific etiology of the problem cannot be clearly identified, and treatment. This study addresses methodological shortcomings that have plagued previous. Back pain is one of the top reasons people seek medical treatment. The effectiveness of acupuncture in treating chronic non. Chronic back pain is a major public health problem and the primary reason patients seek acupuncture treatment. Acupuncture for low back pain no longer recommended for. The optimal management of nonspecific low back pain appears. The data do not allow firm conclusions about the effectiveness of acupuncture for acute lowback pain.
There is 58% life time prevalence of back pain in the uk, a 2265% 1year prevalence and 67% of all adults have constant back problems 2. Acupuncture treatment of chronic lowback pain a randomized. Common questions about chronic low back pain american. Acupuncture in patients with chronic low back pain. In brazil about 10 million people become disabled by low back pain 3. Mfr is a form of manual medicine widely used by physiotherapists in the management of different musculoskeletal pathologies. Effective for services performed on or after january, 21, 2020, cms will cover acupuncture for medicare patients with chronic lower back pain clbp. Chronic pain, whether from a pinched nerve, sciatica, arthritis or other conditions can be very frustrating for the sufferer. There are many therapeutic strategies, but longterm effects of single therapeutic approaches remain limited van tulder et al. Exercise and auricular acupuncture for chronic lowback pain. Pdf chronic back pain is a major public health problem and the primary reason patients seek acupuncture treatment. Pdf this case report details the unexpected and sustained relief from chronic low back pain in a patient after a single acupuncture treatment. To investigate the effects of an isolate myofascial release mfr protocol on pain, disability, and fearavoidance beliefs in patients with chronic low back pain clbp.
Acupuncture for low back pain no longer recommended for nhs. In all five measures of efficacy chosen for study the acupuncture group. Acupuncture for chronic low back pain in longterm follow. Acupuncture is a family of procedures that originated in traditional chinese medicine. A case series allyson augusta shrikhande, md,1 robert a. For the purpose of this decision, clbp is defined as. Acupuncture is the selection and manipulation of specific acupuncture points by penetrating the skin with fine needles. There is a range of acupuncture variants which originated in different. It can cause many physical, mental, and emotional problems on the victim mendelson, selwood, kranz, loh.
Working adults ages 18 to 64 represent 63% of the population and account for 72% of all low back pain lbp health care visits. A singleblind, randomised, placebocontrolled trial of superficial acupuncture in the treatment of low back pain was carried out by comparing 8 patients treated by acupuncture with 9 patients treated by placebo. Patients with subacute low back pain 12 weeks or less andor chronic low back pain more than 12 weeks were included. The data do not allow firm conclusions about the effectiveness of acupuncture for acute low back pain. To evaluate the feasibility of a randomized controlled trial investigating the optimal number of treatment sessions of acupuncture. Most have been of low methodologic quality, and, accordingly, metaanalyses based on these rcts are of questionable interpretability and value. The effectiveness of acupuncture in nonspecific chronic low back pain. The patients had significantly increased depression, neuroticism, and hypochondriasis scores. Efficacy of acupuncture and electroacupuncture in patients.
Acupuncture, a complementary therapy for the treatment of chronic pain, works by stimulating the nervous system and allowing for the body to regain balance in december 2007, the center for complementary medicine research out of munchen, germany filed a report on the efficacy of. For chronic lowback pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the shortterm only. Electroacupunture, acupuncture, low back pain, physiotherapy background low back pain is a serious public health and socioeconomic problem worldwide. Original investigation acupuncture in patients with. Acupuncture for chronic low back pain in routine care. Low back pain is an extremely common concern, affecting anywhere from 75 to 90 percent of people at some point in their lives. Effects of myofascial release in nonspecific chronic low back. For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the shortterm only. Up to 12 visits in 90 days are covered for medicare beneficiaries. Stratification strategies based on identifying patients prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research. Acupuncture involves the insertion of fine metallic needles into the body at. Patients report more pain relief from acupuncture than conventional treatment. For example, the american society of anesthesiologists states it may be considered in the treatment for nonspecific. The optimal management of nonspecific low back pain appears to be undecided.
Disc degeneration and facet joint degeneration have been correlated. But this ageold practice is now viewed as an acceptable supplementary treatment for certain low back pain, neck pain, and osteoarthritis conditions. Low back pain results in high health costs and incapacity to work causing an economic burden to society. This thesis investigated the effectiveness of acupuncture in the management of low back pain, with a focus on one aspect of dosage, i. Therefore, an objective assessment of acupuncture efficacy is critical for making informed decisions about its appropriate role for patients with this common condition.
Low back pain is second only to the common cold as a cause of lost days at work and is one of the most common reasons to seek medical care, including acupuncture. Acupuncture is a pseudoscience because the theories and practices of tcm are not based on scientific knowledge, and it has been characterized as quackery. Guidelines nationally covered indications effective for services performed on or after january 21, 2020 cms will cover acupuncture for medicare patients with chronic low back pain. Superficial acupuncture in the relief of chronic low back pain. Feb 01, 2011 using the incremental costeffectiveness ratio icer, i. Acupuncture for chronic low back pain in older patients. As a medicare advantage plan, ucare covers all items and services that medicare covers. Routine reimbursement for acupuncture in germany for chronic low back pain and osteoarthritis of the kneea. A 45yearold construction worker with a 7year history of intermittent low back pain is seen by his family physician.
The result highlights central questions about how acupuncture helps people with chronic pain. Effectiveness of acupuncture for low back pain wildwood. The middle initial of the second author page 454 was incorrect as published. To determine if acupuncture is an effective, safe adjunctive treatment to standard therapy for chronic low back pain lbp in older patients. Acupuncture is not more effective than other conventional and alternative. This thesis investigated the effectiveness of acupuncture in the management of low back pain, with a focus on one aspect of. Standardized versus individualized acupuncture for chronic. The good news is chronic low back pain is one of the conditions that research suggests acupuncture may be an effective tool for treating. We aimed to compare the effectiveness of standardized and individualized acupuncture treatment in patients with chronic low back pain. The middle initial of the second author page 454 was incorrect as. Nearly 8 out of every 10 people will have low back pain at some point in life. Chronic pain caused by lumbar stenosis remains a challenging clinical issue.
Patients with chronic low back pain are more likely to see a family physician 65. Chronic lowback pain lbp is an important health issue in western countries and is associated with high medical expenses, disability, and inability to work van tulder et al. Decision memo for acupuncture for chronic low back pain. Effectiveness of acupuncture for nonspecific chronic low back pain. Acupuncturelike treatments improve low back pain national. Top synonym for low back pain another word for low back pain is lumbago. Mar 24, 2016 acupuncture is no longer recommended as a treatment for low back pain on the nhs, according to new draft guidelines released today by the national institute for health and care excellence nice. Superficial acupuncture in the relief of chronic low back. Trigger point acupuncture treatment of chronic low back pain in received treatment at traditional acupuncture points for low back pain, while the other. Application of acupuncture to treat low back pain page 2. Initial pain levels correlated with stateanxiety, depression, pain duration. Rcts that included subjects with low back pain caused by specific pathological entities such as infection, metastatic diseases, neoplasm, osteoporosis, rheumatoid arthritis or fractures were excluded. Acupuncture is no longer recommended as a treatment for low back pain on the nhs, according to new draft guidelines released today by the national institute for health and care excellence nice. This study addresses methodological shortcomings that have plagued previous studies evaluating acupuncture for.
Complementary and alternative medicine cam therapies are widely used 510, and acupuncture was shown to be useful for chronic low back pain 1114. A treatment for lower back pain chronic lower back pain is a major health disorder in the world today mendelson, selwood, kranz, loh, kidson, scott, 1983. Chronic low back pain clbp is a major health issue in the western world and is a significant burden on health care. Considering how challenging it is to translate research into. Costeffectiveness of acupuncture treatment in patients with chronic neck pain. Chronic low back pain clinical outcomes present higher. Acupuncture a is a form of alternative medicine and a key component of traditional chinese medicine tcm in which thin needles are inserted into the body. Setting a tertiarylevel pain clinic at a swedish university hospital. Aug 19, 2015 stratification strategies based on identifying patients prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research. Acupuncture for chronic low back pain cag00452n decision.
Back pain was the most common, followed by joint pain, neck pain, severe headachemigraine, and recurring pain. Chronic low back pain lbp is an important health issue in western countries and is associated with high medical expenses, disability, and inability to work van tulder et al. Pdf acupuncture treatment of chronic low back pain by using. Acupuncture and simulated acupuncture both improved chronic low back pain more than conventional care in a new study. Low back pain is a common musculoskeletal disorder defined as pain and soreness, muscle tension, or stiffness in the lumbosacral area of the spine which does not have a specific cause. Acupuncture is generally only used in combination with other forms of treatment. Chronic low back pain is a major health problem in western countries, and is associated with high medical expenses, lost productivity, and disability. Acupuncture and dryneedling for low back pain cochrane.
Patients fifty consecutive patients 33 women, 17 men. Acupuncture is widely used by patients with low back pain, although its effectiveness is unclear. The acupuncture treatment costs are reimbursed by the german statutory health insurance companies. Pdf efficacy of acupuncture for chronic low back pain. Nonspecific low back pain is a common musculoskeletal disorder that has become a major health and economic problem hoy, et al. Up to 12 visits in 90 days are covered for medicare beneficiaries under the following circumstance.
868 80 742 557 757 1308 260 246 1415 601 1502 68 544 661 362 192 584 39 557 1000 456 158 440 95 605 558 857 346 865 38 488 1006 1330 70 478 634 926 390 109 1388 931