Acupuncture For Back Pain Melbourne Northern Suburbs
Acupuncture Treatment for Low Back Pain
Low back pain is a very common reason why new patients come to see us in our northern suburbs based clinic. Acupuncture for a bad back has been a heavily researched area. The body of evidence acknowledges what many Chinese medicine practitioners already know, that for the treatment of acute and chronic low back pain acupuncture may an effective option.
Causes of Back Pain
Back pain is a very common problem, and it affects up to 3 million Australians. Low back pain was ranked 3rd in a 2010 US study for the burden the condition in terms of mortality and poor health (1). Only about 1% of cases lasting for more than 6 weeks is due to a serious underlying cause, another 5% of cases have referred pain or radiculopathy such as Sciatica . The remaining 94% are considered non specific low back pain and do no have a discernible cause (2). In most cases it is considered a mechanical issue, as opposed to a neural issue.
Risk Factors for Low Back Pain
Aside from trauma, there are a number of things that can be associated with the development of back pain
- Lifestyle causes such as not doing enough exercise, continued heavy lifting and poor posture
- Some health issues may be related to back pain such as arthritis (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, osteopaenia and osteoporosis, and narrowing of the spinal canal (spinal stenosis).
- Some risks factors for the development of chronic low back pain include negative view of recovery, work related issues, and depression and anxiety
Chances of back pain being related to cancer, fracture, spinal compression etc is very rare. At our acupuncture clinic we may send you back to your GP for further examinations and referral.
Types of Low Back Pain
Typically at our clinic we see both acute, subacute and chronic low back pain.
- Acute low back pain is defined as lasting for fewer than 4 weeks
- Subacute low back is defined as lasting between 4-12 weeks
- Chronic low back pain (AKA persistent back pain) is defined as lasting for more than 12 weeks
Generally we see people during all three stages. The majority is non specific low back pain, primarily presenting with muscular pain in the low back, buttock and/or hip. Often it will affect the range of motion and the ability of the patient to move around freely. Sometimes you may find it difficult to stand up straight and find it difficult to move around, especially in the early stages. Pain may be quite severe.
Should I Have an Xray or MRI for my Back Pain?
Often we are asked this question and we tend to answer it the same way - in most cases imaging such as an X-ray or MRI are not useful nor recommended, especially in the beginning unless red flags are present. Why unnecessarily expose yourself to radiation if it can be avoided. Sometimes the results from such tests may show things that may have already been there prior to your test and are unrelated to the reason you are experiencing back pain. We advise you to discuss this further with your GP.
Conventional Back Pain Treatment
Conventional treatment for lower back pain is generally conservative and focused around helping those affected with low back pain to manage your levels of pain. NPS has the following recommendations for health professionals treating acute low back pain (2).
- Continuing with normal activities. In the past bed rest and reducing activities was advised. Now the focus is to keep up with normal activities such as going to work, shopping etc, which are more likely to have a positive effect upon your back pain recovery. This also has a beneficial affect upon mental health especially when they are reassured that things are very unlikely to be serious.
- Exercise. A guided exercise program can be a useful way to manage pain and although the evidence for exercise has yet to be clear cut, there seems to be a view that it may be helpful for the management of pain. In cases of chronic and subacute low back pain it may speed your recovery (1). In order to manage Chronic pain your GP may refer you to an exercise physiologist for the development of a guided exercise plan.
- Heat. Heat can be another effective non pharmacological way of managing pain and improving your range of motion.
- Medications. In some cases in order for you to be able to do daily living activities or to continue with normal activities. NSAID's such as ibuprofen may be suggested over analgesics like paracetamol due to recent developments regarding efficacy. Your Gp will discuss with you your options.
- Surgery. In circumstances where other approaches have been unsuccessful for treating your back pain, or your symptoms are worsening, surgical interventions may be discussed with you and you may be further referred to a orthaepaedic or neurology specialist.
Further non pharmacological interventions such as Acupuncture may be recommended by your GP to help treat and manage your low back pain.
How Does Acupuncture Stop Pain?
Firstly let's acknowledge that pain, and how we perceive it, is complex. There are few mechanisms listed in the literature of how acupuncture reduces pain.
- Acupuncture releases swift acting natural painkillers (3,4,5,6,7,8)
- Acupuncture reduces perception of pain (9)
- Acupuncture reduces inflammation and swelling (10, 11)
- Acupuncture releases tight muscles (12)
For a more in depth discussion, refer to the article we wrote about using Acupuncture for Treating Pain
Does Acupuncture Help With Low Back Pain?
Yes, and the evidence supporting the use of acupuncture is getting better as the body of research continues to grow. For chronic low back pain the research is quite conclusive that acupuncture can help those with low back pain and should be advocated as part of routine clinical care (13). Another study found that acupuncture was superior to conventional care (14). Acupuncture was also reported as being a cost effective treatment for low back pain in two further studies (15, 16).
For acute low back pain acupuncture was reported as being superior to NSAID's for improving symptoms (17) and another study reported acupuncture also reported improvements for pain and function (18). In both studies there were some issues with the quality of evidence and the risk of bias. Overall though the evidence shows that acupuncture has a potentially positive effect. Further high quality studies are needed to be able to upgrade the affect of acupuncture on acute low back pain in line with chronic low back pain.
The Opioid Crisis and How Acupuncture Can Help
Many of you will have read about the opioid crisis. The misuse and addiction to opioid based medications has lead to drug overdoses becoming the leading cause of death in those under 50 in the US. Much of this problem affects North America and came about due to the over prescription of opioids for pain relief under the misguided view that opioids would not become addictive. As a result to the issue becoming so widespread, attention started to focus on alternatives to pharmacotherapy, specifically alternatives to the use of opioids. Acupuncture is an effective non-pharmacotherapy option and low risk option for the treatment of pain (14, 18). We look forward to seeing acupuncture becoming not only part of routine clinical care for the treatment of low back pain, but also to see acupuncture recognised as part of the medicare rebated Chronic Disease Management Scheme so it can be accessible to more people.
Back Pain Treatment Melbourne
The amount of acupuncture sessions required to treat your low back pain will depend a bit on how long you had the problem. Clinically we find chronic low back pain will require more sessions, but as is often the case, this will vary depending on your individual circumstances.
Prior to giving you some acupuncture treatment, we will have a chat to you about your condition, how long you have had it, what makes it worse, what makes it better etc. We may take your pulse and palpate around where it is sore.
We will then chat to you about what we intend on doing and how many acupuncture sessions may be required to treat your low back pain. Typically during your acupuncture session the needles will be left in place for about 20 minutes. We may use electroacupuncture, cupping, massage or other additional approaches to help with your pain, but this will be discussed with you. After treatment we will then arrange another appointment to continue to work on your issue.
What Else Can Help My Low Back Pain?
A good positive attitude may help you with managing your pain and discomfort. We wrote an helpful article to assist you with choosing a guided mindfulness session. Activity and exercise are good idea, as mentioned above, and aside from getting some acupuncture at our clinic we suggest you check out some more tips for managing your back pain.
Our Clinic - Low Back Pain Northern Suburbs
Based in Melbourne, the Coburg Clinic services people from Coburg and surrounding Northern suburbs such as Brunswick, Pascoe Vale, Preston, Fawkner, Thornbury, Northcote. If you wish to discuss how acupuncture can assist you call us on 03 9041 656
Call us on ☎ (03) 9041 6569 to arrange an appointment or book online below
1. NINDS (2014) Low Back Pain Fact Sheet. Retrieved 15 January 2018, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
2. NPS (2016) Management of Acute Non-Specific Back Pain, Retrieved 15 January 2018, https://www2.health.vic.gov.au/Api/downloadmedia/%7BE39CADF7-A680-450E-A675-311992CBE8BD%7D
3. Pomeranz B. Scientific basis of acupuncture. In: Stux G, Pomeranz B, eds. Acupuncture Textbook and Atlas. Heidelberg: Springer-Verlag; 1987: 1-18.
4. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol. 2008; 85: 355-75.
5. Zhou Q et al. The effect of electro-acupuncture on the imbalance between monoamine neurotransmitters and GABA in the CNS of rats with chronic emotional stress-induced anxiety. Int J Clin Acupunct2008 ;17: 79-84.
6. Lee B et al. Effects of acupuncture on chronic corticosterone-induced depression-like behavior and expression of neuropeptide Y in the rats. Neuroscience Letters 2009; 453: 151-6.
7. Cheng CH et al. Endogenous Opiates in the Nucleus Tractus Solitarius Mediate Electroacupuncture-induced Sleep Activities in Rats. Evid Based Complement Alternat Med 2009 Sep 3.
8. Goldman N et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci 2010 May 30.
9. Hui K.K.-S. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Human Brain Mapping 2009; 30: 1196-206.
10. Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther 2007; 6: 251-7.
11. Zijlstra FJ et al. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003; 12: 59-69.
12. Omori M et al. Microcirculatory responses to acupuncture stimulation and phototherapy. Anesth Analg 2009; 108: 635-40.
13. Liu L, Skinner M, McDonough S, Mabire L, Baxter GD. Acupuncture for low back pain: an overview of systematic reviews. Evid Based Complement Alternat Med. 2015;2015:328196.
14. Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clin Proc. 2016 Sep;91(9):1292-306.
15. Taylor P, Pezzullo L, Grant SJ, Bensoussan A. Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain. Pain Pract. 2014 Sep;14(7):599-606.
16. Andronis L, Kinghorn P, Qiao S, Whitehurst DG, Durrell S, McLeod H. Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review. Appl Health Econ Health Policy. 2016 Aug 22.
17. Lee JH, Choi TY, Lee MS, Lee H, Shin BC, Lee H. Acupuncture for acute low back pain: a systematic review. Clin J Pain. 2013 Feb;29(2):172-85.
18. Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. AHRQ Comparative Effectiveness Reviews. Noninvasive Treatments for Low Back Pain. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.