Acupuncture and the Treatment of Lower Back Pain
ACUPUNCTURE AND THE TREATMENT OF
LOWER BACK PAIN
Lower back pain is the second most common cause of missed work days due to illness and the most common cause of missed workdays due to disability[i]. High risk groups include; those who spend long periods of time sitting and leaning forward such as office workers or commercial drivers as well as those who engage in activities which involve trunk rotation combined with flexion for eg. Golfers and brick layers.
When we lean forward, the flexion of our lumbar spine causes the fluid in the centre of the disc to shift backwards. This movement places pressure against the layers of the disc at the rear of the spine which over time can become weakened and predispose to acute disc injury (disc bulge or prolapse) and to chronic inflammation of the outer layers of the disc (inflammation of the annulus fibrosis).
Although certain activities can predispose towards lower back injury an active lifestyle is preferable to a sedentary one with a recent study showing that the amount of pressure in the intervertebral discs is higher in the seated position than either standing or walking[ii]. Maintaining strength and flexibility are essential in the prevention of lower back issues as muscle imbalance will lead to an increased incidence of soft tissue injury and degenerative changes.
Acupuncture has been used in China for the treatment of back pain for over 2000 years and is being increasingly utilized in the west. Chinese Medicine and acupuncture are now registered with the Australian Health Practitioner Regulation Agency and in other western countries it is rebated as part of their government health schemes (New Zealand and Germany). Due to the high number of patients receiving acupuncture in Germany there have been several high quality studies done in recent times. In the 2007 study performed by Haake et. al. acupuncture was shown to have almost twice the benefit of standard care alone (a combination of drugs, physical therapy, and exercise) in reducing back pain at a 6 month follow up after a course of acupuncture treatment[iii]. Acupuncture is recognized by all of the major private health funds in Australia.
There are specific points which access each spinal level that were first recorded by the great acupuncturist Hua Tou (140-208AD) in the Eastern Han Dynasty. With small changes to the angle of insertion and depth it is possible to focus the treatment of these points to either the local spinal musculature, the disc or the facet joints of the spine. These points combined with treatment of the motor points of the involved musculature and then supported with points to enhance the underlying constitutional health of the body, enable much faster recovery from injury and pain relief[iv].
It is essential that the acupuncturist has had extensive training for this style of work and not just a short course. Please look for a degree level of qualification and registration with the Chinese Medicine Board of Australia when choosing your acupuncturist.
Treatment usually starts with 2 session a week for 2-3 weeks and then moves to weekly intervals to manage the sub-acute stage of recovery. For more chronic milder cases once a week is adequate to assist in the healing response.
[i] Frymoyer JW, Cats-Baril WL: An overview of the incidences and costs of low back pain. Orthop Clin NORTH Am 2001;22(2): 263-271
[ii] Oshima, J.P., Urban, D. H. Effect of applied load to the intervertebral disc measured in vitro by a new perfusion technique. Journal of Orthopaedic Research, v.13. p. 22-29. Jan. 2005
[iv] Callison, M. Low Back and Leg Pain (Yao Tui Tong ) lecture notes, Aukland New Zealand August 24-25th 2013