Acupuncture proves to be safe and effective for chronic back pain

By Stephen Beech

Acupuncture is a "safe and effective" treatment for back pain in older people, according to new research.

Chronic back pain patients aged over 65 treated using the traditional Chinese method involving the insertion of needles into the body had greater improvement in physical function and reduced pain than those who received usual medical care, say American scientists.

The condition is the leading cause of disability worldwide, and affects over one-in-three older adults.

Treatment options range from pain-relieving drugs to complementary therapies, including acupuncture.

Study lead author Dr. Lynn DeBar said: “Of the different treatments we have for chronic low back pain, most have a somewhat modest effect.

"They often reduce pain by about a third at best and can help people function better.

“Our clinical results suggest that acupuncture is working as well as many things that are more familiar to people.

"We found that the size of this effect, while modest, was positive and sustained.”

The BackInAction clinical trial enrolled 800 participants, with results based on self-reported pain-related disability assessments following treatment that either included or omitted acupuncture.

Researchers looked at whether manual acupuncture needling could improve function and reduce pain for older people who have chronic or persistent lower back pain.

The manual acupuncture needling technique entails inserting fine needles into the skin at points that follow a prescribed anatomical grid.

The practice provides various benefits, including reduced discomfort from back, joint or neck pain.

While acupuncture has been found to be safe and effective for chronic low back pain in adults overall, few studies have focused on senior citizens.

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Participants in BackInAction included men and women aged 65 and older with a medical history of low back pain for at least three months.

All the participants had health coverage and were not restricted from receiving usual medical care for their back pain.

A third of those received up to 15 acupuncture treatments over three months, while another third received an additional six acupuncture treatments over the following three months.

At three study milestones - after three, six and 12 months from enrolment - participants provided self-assessment of their pain and physical limitations.

Their agreement with any of 24 statements that describe everyday activities made difficult because of back pain contributed to the participant’s disability score.

The research team used additional tools for insights into pain levels, degree of physical functioning, depression and anxiety.

Their findings, published in JAMA Network Open, showed that, at the six-month and 12-month assessment, both groups who received acupuncture had greater reductions in pain disability than those who received usual medical care alone.

The acupuncture-treated groups also had reduced pain intensity and greater physical function after six months compared to participants who did not receive acupuncture.

The researchers also reported that acupuncture treatment was associated with fewer anxiety symptoms as compared to usual medical care alone at the six and 12-month assessments.

Dr. DeBar, of the California-based health consortium Kaiser Permanente, said: “What sets the BackInAction study apart is that it focused specifically on adults 65 years of age and older, and it was pragmatically designed.

“We worked hard to involve adults in multiple regions of the country so that participant demographics were consistent with the US census for older adults - and we worked with licensed acupuncturists in the community, who are most likely to deliver these services.”

The research team suggests that access to acupuncture is important for older adults with chronic back pain and that if acupuncture practitioners could bill Medicare directly it could greatly improve access to such services.

Co-lead researcher Dr. Andrea Cook, Kaiser Permanente senior biostatistics investigator, added: “We saw very little in the way of adverse effects during the clinical trial.

“Older adults often are dealing with other medical problems in addition to back pain.

"Acupuncture offers a less invasive option that has a better safety profile than a lot of the common treatments for back pain in older adults.”