Back pain is something that nearly everyone can relate to; according to

statistics from the Mayo Clinic, four out of five people will experience

some form of back pain in their lifetimes. Treatment for such pain can

vary greatly in modern medicine. Many who experience it are told

by a medical professional to use heat, take over the counter

anti-inflammatory medicines, or for more severe pain, attend physical

therapy sessions. If these "simple" treatments do not work, there is

the option for more powerful pain medicine, to direct spinal steroid

injections, all the way up to surgery that fuses multiple vertebrae

together. If one chooses an alternative treatment, acupuncture is

common for treating back pain.

Given all these options—conventional conservative techniques, surgery, and alternative measures—which is best? A new study by a German team of researchers and physicians asks whether acupuncture is a worthwhile treatment for lower back pain, the details and results of which will appear in an upcoming issue of the Archives of Internal Medicine. To investigate the effectiveness of acupuncture at healing back pain, the researchers carried out a randomized clinical trial that consisted of over 1,000 patients. Each participant had experienced chronic back pain for a minimum of eight years and underwent a series of ten 30-minute sessions for treatment of their pain.

The participants received one of three types of treatment—387 received verum acupuncture, 387 received sham acupuncture, and 388 received conventional therapy. Verum acupuncture is based on placing the needles at points and depths specified by traditional Chinese techniques. Conversely, sham acupuncture was just that, a sham, needles were placed away from known verum points and meridians and were only sunk to a superficial depth. The conventional therapy included a combination of medicine, physical therapy, and exercise. To quantify the effectiveness of the therapies, the researchers measured the response rate, which is defined as a patient reported 33 percent reduction in pain or a 12 percent increase in functional ability. Six months after treatment, the response rate for the verum acupuncture group was 47.6 percent, for the sham acupuncture it was 44.2 percent, and for the conventional therapy group it was a mere 27.4 percent.

The authors conclude that "the superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals or processing of pain signals by the central nervous system and that is stronger than the action mechanism of conventional therapy." Whether or not this is indeed the case, or this is an example of the placebo effect, it suggests another viable option for those suffering from back pain.

Archives of Internal Medicine 2007; 167(17):1892