Acupuncture May Help Reduce Low Back Pain

Acupuncture May Help Reduce Low Back Pain Blog  Low back pain Acupuncture

Low back pain has become a major global health concern with nearly 70% of the industrialized world’s population afflicted. The lack of adequate treatment for this chronic pain has caused severe comfort of life problems among the millions of individuals who combat it day and night. While physical therapy and pain medications are the standard care for most patients, many seek alternative treatments to either augment or entirely supplant the usual care methods. One such treatment is acupuncture, an ancient Chinese practice using thin needles to release pressure points on the body. Acupuncture for pain management has increased lately in popularity because of the lack of options patients face when combating the day to day struggle of a sometimes debilitating pain.

Like most non-Western approaches to medicine, the academic community has relatively little to say about acupuncture’s effectiveness. However, a recent study by the Centre for Health, Activity and Rehabilitation at the University of Otago examines the effectiveness of acupuncture for the treatment of low back pain and reveals that the practice may be useful in relieving pain and increasing functionality when used in addition to physical therapy. The study, a survey of sixteen unique clinical trials, reveals that even in a scientific study, there are no clear cut answers that prove or disprove the effectiveness of acupuncture for low back pain.

Often, these studies do little to separate acupuncture from the stigma that it is unscientific, but this overview reveals that some trials that have treated the practice as medicine and studied its effects in the same manner as more mainstream low back pain treatments. Ultimately, an open-mindedness of the medical community to study alternative treatment will be the key to understanding more about pain treatment, which can only bring positive results to the millions of individuals afflicted by this debilitating pain. Cultural bias or fear of the unknown should not deter scientific progress, a role which the public plays just as strong of a role to be willing to explore new treatments. However, the public cannot put its trust in new methods of treatment unless their physicians can speak to the benefits and shortcomings of each method knowledgably.

There are several conclusions we can make about acupuncture based on these trials. Though no study supports a recommendation of only acupuncture for low back pain, the use of acupuncture as an addition to a more standard pain management plan is either tolerated as “not harmful” or, in some cases, is encouraged due to positive results. There were many instances in which patients using true acupuncture versus those who were administered a kind of placebo (i.e. no penetration of the needles, incorrect points on the body) experienced very positive results while the placebo groups reported nothing. Though there were some cases that contradicted this, a general statement about the use of acupuncture for low back pain is that it can be helpful if used in addition to physical therapy but should not fully replace a more standard pain management program.

Ultimately acupuncture is a personal choice for individuals open to exploring alternative possibilities to treating pain. According to the most modern science on the practice, patients may feel relief in the short term after acupuncture treatment- many have reported comfort and less pain. However, the disappointment that accompanies another failed pain treatment method may be too frustrating. Both instances have occurred as evidenced in these trials. It seems that currently, pain relief is far too personal for the scientific process to make a definitive statement on this particular method, which may a comfort more personal than a study can explain. Ultimately, what the recent study reveals is that there has not been enough clinical examination of acupuncture for low back pain. While the medical community’s support remains with the standard method of low back pain treatments, management of pain medication and physical therapy, there is an ever-growing community of individuals exploring new methods of treating their pain. In the case of acupuncture the “new” treatment is an ancient practice with a history rooted deeply in Chinese culture. Perhaps a little more relief can be found through acupuncture, time will tell if it should be a part of the long-term plan.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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