Monday, May 11, 2009
Last updated 1:00 p.m. PT
By VANESSA HO
In the country's largest study of back pain and acupuncture, researchers at Group Health found that acupuncture and an acupuncture-like treatment involving toothpicks relieved chronic low-back pain better than customary medical care, which included medication and physical therapy.
The study also found that the toothpick method, which involved no piercing of skin, was just as effective as needle insertion.
Published in Monday's Archives of Internal Medicine, the study randomly assigned more than 600 people with uncomplicated, low-back pain to three types of treatment. The treatments, which lasted seven weeks, included:
A fourth group of people received no treatment and was allowed to seek any medical care they would normally seek for back pain.
The participants, who came from Group Health and a nonprofit health plan in California, all initially rated their back pain's "bothersomeness" as at least a "3," on a 0-to-10 scale. Their pain had to have lasted for at least three months.
Researchers found that 60 percent of the treated patients felt significantly better at eight weeks, versus only 40 percent of the untreated patients.
At 52 weeks, pain scores for both groups were about the same. But researchers also measured functioning levels -- such as the ability to work or run errands -- and found that the treated group had higher functioning scores than the untreated group a year after treatment began.
The study also found no difference in outcomes from the various treatments. That finding echoed previous studies that found that acupuncture -- a traditional Chinese practice of inserting needles to release qi, or energy -- is no more effective in relieving pain than "sham" acupuncture used in control groups.
Those sham methods have included relatively shallow needle insertion, insertion at non-acupuncture points, and no insertion at all.
What does it all mean? The study's authors, from Group Health's Center for Health Studies, offered a few theories. They said stimulation of acupuncture points -- without needle insertion -- may be enough to rouse physiological changes that reduce pain and improve functioning.
Another theory held that the light touching of skin might induce emotional and hormonal reactions for pain reduction. A third explanation lay in the possibility that the treatment "experience" itself made people feel better.
"This adds to the growing body of evidence that something meaningful is taking place during acupuncture treatments outside of actual needling," said Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine. The center, which is part of the National Institutes of Health, funded the trial.
The study's authors, Daniel Cherkin and Karen Sherman, wrote that back pain prompts Americans to spend $37 million a year on medical care, and is the leading reason for visits to acupuncturists.
Rebecca Hughes, a spokeswoman for the Center for Health Studies, said the authors are focused on helping people get better without pills or surgery.
"They're really interested in healing, and the mind-body connection," she said.
Vanessa Ho can be reached at 206-448-8003 or email@example.com.
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