Acupuncture - real or fake - best for back pain

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CHICAGO - Fake acupuncture works nearly as well as the real thing for low back pain, and either kind performs much better than usual care, German researchers have found.

Almost half the patients treated with acupuncture needles felt relief that lasted months. In contrast, only about a quarter of the patients receiving medications and other Western medical treatments felt better.

Even fake acupuncture worked better than conventional care, leading researchers to wonder whether pain relief came from the body’s reactions to any thin needle pricks or, possibly, the placebo effect.

Acupuncture represents a highly promising and effective treatment option for chronic back pain,” study co-author Dr. Heinz Endres of Ruhr University Bochum in Bochum, Germany, said in an e-mail. “Patients experienced not only reduced pain intensity, but also reported improvements in the disability that often results from back pain and therefore in their quality of life.”

Although the study was not designed to determine how acupuncture works, Endres said, its findings are in line with a theory that pain messages to the brain can be blocked by competing stimuli.

Positive expectations the patients held about acupuncture — or negative expectations about conventional medicine — also could have led to a placebo effect and explain the findings, he said.

In the largest experiment on acupuncture for back pain to date, more than 1,100 patients were randomly assigned to receive either acupuncture, sham acupuncture or conventional therapy. For the sham acupuncture, needles were inserted, but not as deeply as for the real thing. The sham acupuncture also did not insert needles in traditional acupuncture points on the body and the needles were not manually moved and rotated.

After six months, patients answered questions about pain and functional ability and their scores determined how well each of the therapies worked.

In the real acupuncture group, 47 percent of patients improved. In the sham acupuncture group, 44 percent did. In the usual care group, 27 percent got relief.

“We don’t understand the mechanisms of these so-called alternative treatments, but that doesn’t mean they don’t work,” said Dr. James Young of Chicago’s Rush University Medical Center, who wasn’t involved in the research. Young often treats low back pain with acupuncture, combined with exercises and stretches.