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Acupuncture is almost twice as effective as conventional therapy at treating low back pain, new study says. Over 1,100 patients with a history of chronic low back pain lasting on average 8 years took part in clinical trials. Traditional Chinese Medicine acupuncture was tested against the effects of sham acupuncture (placing needles in non-acupuncture points on the body) and conventional therapy (a combination of drugs, physical therapy and exercise). Patients received ten 30-minute acupuncture sessions, generally two times a week. After 6 months, the results showed that pain reduction was sustained for 48% in the acupuncture group, compared with 27% in the conventional therapy group.
The findings add to a growing body of evidence supporting the effectiveness of acupuncture in treating low back pain. However in the NHS, the question is not only 'does it work?' but also 'how much does it cost?'. With a rising drugs bill, searching for cost-effective solutions is important, and research on acupuncture is now starting to address the question of costs also. A study by the University of Sheffield showed that traditional acupuncture offers a cost-effective intervention for reducing non-specific low back pain over a two-year period compared with conventional GP care. In the acupuncture care group 159 volunteers received up to 10 individualised treatments, while 80 received conventional treatment. At the two year follow-up, the results showed that that the acupuncture care was significantly more effective in reducing bodily pain than usual through conventional care, and those patients were also less likely to report the use of medication for pain relief. However no benefits to function or disability were identified.
The research demonstrated the effectiveness of traditional Chinese acupuncture at sustaining reduced pain levels and its knock-on effects for reduced medication consumption over time. Often a shortcoming of many clinical trials is that they do not assess the long-term effects of intervention, so what may appear cost-effective in the short term, may not be over a number of years. It is encouraging that research is starting to provide the evidence-base for traditional acupuncture and offering GPs and others working in healthcare another tool at their disposal which they can use to help patients. As the Sheffield study says, perhaps the next step is to compare acupuncture against other complementary packages of care (such as massage, chiropractic or physiotherapy) to look at costs, and appropriate treatment packages for particular patients.
The German study was undertaken to address the question of whether acupuncture should continue to be included in the social health care reimbursement system. As use of acupuncture by the UK public is becoming more commonplace and with high levels of satisfaction reported, free access to acupuncture becomes an issue for the NHS and private health care insurance companies here.
References:
Haake M et al (2007) German acupuncture trials (GERAC) for chronic low back pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups. Archives of Internal Medicine; 167:1892-1898
Thomas KJ et al (2005) Longer-term clinical and economic benefits of offering acupuncture care to patients with chronic low back pain. Health Technology Assessment, University of Sheffield. Aug; 9 (32): iii-iv, ix-x, 1-109.
Thieme Almanac (2007) Acupuncture and Chinese Medicine. Germany: Georg Thieme Verlag