Application of Acupuncture to Treat Low Back Pain
Working adults (ages 18 to 64) represent 63% of the population and account for 72% of all low back pain (LBP) health care visits.1Low back pain has been identified categorically as acute, subacute, or chronic, depending on the onset, duration, and severity.1,2 Risk factors have included occupational posture, depressive moods, obesity, gender, and age, and risk is most likely affected by a combination of several of these variables.2 Low back pain is not a disease but rather a group of signs and symptoms that affects all age groups across the lifespan. It has been shown to be more common from age 35 to 55, with a higher prevalence in women.2,3
The World Health Organization anticipates that as the world population ages, the incidence of LBP will increase substantially and become 1 of the leading conditions for which the aging population will seek out medical intervention.2
Acupuncture may help improve quality of life as well as reduce lost workplace productivity through more effective and sustained pain relief.4,5 Stimulating nerves located in muscles and other tissues with the application of fine needles may lead to the release of endorphins and other neuro-humoral factors.6 The expected result is a change in pain processing between the brain and spinal cord.
Acupuncture has demonstrated efficacy in reducing inflammation by promoting the release of vascular and immunomodulatory factors and increasing local microcirculation.6-8 In turn, this may support better joint movement and relief of muscle stiffness as well as aid the healing of swelling and bruising.6,7
While the evidence for acupuncture remains inconclusive, there are a growing number of studies offering clinical support for the benefits of using acupuncture to address LBP.6-10 (See Four Pillars of Chinese Medicine)
Four Pillars of Chinese Medicine
- Looking at physical attributes such as the face, eyes, gait, and tongue is the first pillar. We examined the map of the tongue as it laid out the internal viscera and details of the tongue such as shape, color, texture, moisture, coating thickness and color, size of the papillae, and movement, as these features can be very revealing.
- Listening is a second pillar in the evaluation. The patient’s voice might offer evidence of a disturbance or irregular pattern.
- Palpation is the third pillar. For example, the pulse, like the tongue, presents a blueprint of a patient’s condition. The left and right side of the radial pulse is laid out into 3 sections (from proximal to distal): qi, guan, and cun. Each pair of organs can be recognized within each of these positions. Palpating the pulse is an extremely detailed task requiring complete focus to feel for the quality. The pulse has several attributes that serve as a window between the practitioner and the patient, including the depth, strength, consistency, and even the specific movement in which the blood travels through the vessel.
- Asking is the final pillar, which revolves around 10 essential questions that directly correlate to the patient’s overall being and constitution. These questions journey from the chief complaint and project to other life behaviors and inclinations that may encompass tendencies to be either hot or cold (or neither), sweating, gastrointestinal (ie, digestion, urination, bowel movements), sleep quality and quantity, emotional status, energy levels, and pain quality and consistency.
Source: Four Pillars of Chinese Medicine. Available at: http://www.china.org.cn/english/health/225768.htm
In this case review, the pain relief achieved by fascial manipulation was demonstrated through the release of superficial stagnation in the tendinomuscular channels that are responsible for pain; this process has been correlated to benefits in the deeper muscular layers and related meridians.11,12 We used Master Tung points in a special 3-needle arrangement called Dao Ma, in conjunction with a method called Dong Qi (movement Qi) in which the needle is manipulated as the patient exercises the affected area.13
We found that acupuncture’s overall therapeutic effects help in reducing the use of medication for back complaints, providing a more cost-effective treatment over a longer period of time (eg, at least 2 years).5,6,9