Basis, indications and risk: Basis, indications and risk

Treatments Basis, indications and risk Patient information Postural hygiene Exercise Maintaining level of Activity Bed rest Pharmacological therapy Neuroreflexotherapy (NRT) Spinal column surgery Surgery for Pain and Pain Clinics Vertebral manipulation Behavioral treatment Epidural injections Facet joint infections Trigger point and ligament infections Rhizotomy Corsets and lumbar belts Traction Physical therapy/physiotherapy Electromyografic Feedback TENS: Transcutaneous electrical Nerve Stimulation Shoe insoles and shoe lifts Acupunture Recommended treatments

Acupunture

Description

The puncture of specific skin points ("acupuncture points") with needles, which are left in place for several minutes.

Objective

To reduce pain.

Theoretical basis

The process by which acupuncture could have an effect on back pain is unknown.

Some acupuncture advocates maintain that needle puncture may trigger neurological processes, which could explain its effect. However, available scientific data prove that acupuncture points have different electric and radioactive characteristics from the rest of the normal skin, and that these characteristics are not dependent on the subjacent nerve fibers. Therefore potential acupuncture effects could be due to non-neurological processes.

Evidence of efficacy

Several studies have been undertaken to evaluate the efficacy of acupuncture in treating back pain. In general, their scientific quality is rated very low, and they have produced weak and ambiguos results, making it difficult to draw valid conclusions.

For chronic back pain, the existing evidence-based recommendations agree that acupuncture can reduce pain and permit increased activity in patients with chronic back pain, although evidence is weak and results have been contradictory. These guidelines also consistently state that acupuncture is not effective when it is used to treat acute lower back problems.

A more recent systematic review found no evidence available for the efficacy of acupuncture in the treatment of acute lower back pain, and evidence that acupuncture is not effective in the treatment of chronic low back pain.

Risks

Some cases of infectious disease transmission by acupuncture have been reported (hepatitis, AIDS). This risk can be reduced if the acupuncture provider is a physician who applies this technique in appropriate sterile conditions.

Recommendations

The existing evidence-based recommendations do not include the use of acupuncture.