Acupuncture Beats Usual Care at Relieving Back Pain
Even simulated acupuncture with a toothpick works, suggesting a possible placebo effect
15 may 2009-- Acupuncture, even simulated acupuncture using a toothpick, outperformed usual care in relieving low back pain according to a study in the May 11 Archives of Internal Medicine.
Daniel C. Cherkin, Ph.D., of the Center for Health Studies in Seattle, and colleagues randomized a group of 638 low back pain patients to receive one of the following four treatments: standardized acupuncture; individualized acupuncture; simulated acupuncture with a toothpick; and usual care consisting of medication and physical therapy. Each acupuncture subject received 10 treatments over a seven-week period. Outcomes were assessed after eight, 26, and 52 weeks in terms of dysfunction scores and a continuing discomfort scale.
After eight weeks, the researchers note that the groups receiving individualized, standardized, and simulated acupuncture improved on the dysfunction scores by 4.4, 4.5, and 4.4 points respectively, while those receiving usual care improved 2.1 points. Symptom improvement in the acupuncture groups was in the range of 1.6 to 1.9 points compared to 0.7 in the usual-care group. At one year, improvement in dysfunction scores was sustained in the acupuncture groups (range 59 to 65 percent versus 50 percent for usual care).
"Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits," the authors conclude. "These findings raise questions about acupuncture's purported mechanisms of action. It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects."