Jim Galbiati, M.Ac.
Five Element Acupuncture

1350 Pine Street
Suite 3
Boulder, CO 80302

Acupuncture Research: Back pain

Gunn CC, Miibrandt WE, Little AS and Mason KE (1980)
Dry needling of muscle motor points for chronic low-back pain,
Spine 5:279-291

Type of Study: Acupuncture as adjuvant treatment to standard physiotherapy and occupational therapy was compared to standard therapy alone for alleviation of chronic low-back pain.

Research Design: Fifty-six male patients who were being rehabilitated at a workers' compensation clinic for chronic low back pain (average duration 28.6 weeks), and who had already failed standard therapy, were randomly assigned to either continue standard therapy or receive standard therapy plus acupuncture. Standard therapy consisted of physical therapy, remedial exercises and occupational therapy. Acupuncture, with electrical stimulation of the needles, was administered at variable sites depending on the location of the pain, for variable numbers of treatment sessions up to a maximum of 15, (mean 7.9), depending on response to treatment. Assessment of each patient was comprehensive at the start of the study, as each patient had been through an outpatient rehabilitation clinic. Further assessments were made at 12 weeks after the start of treatment, and again at a mean of 27.3 weeks after the start of treatment. These assessments primarily involved determining whether the patient had "no improvement", "some improvement", "good improvement" or "total improvement", and whether the patient had been able to return to any work.

Results: A significantly larger number of patients in the standard therapy plus acupuncture group showed greater improvements than the standard therapy group, both at the 12 week and later follow-ups. Of the 29 patients that received acupuncture, 18 returned to their original or equivalent jobs; an additional 10 returned to lighter employment. Of the 27 patients who received only standard therapy, only 4 returned to their original or equivalent jobs and 14 to lighter employment.

A relatively simple course of acupuncture added into a standard rehabilitation program for patients with chronic back pain was found to significantly improve the treatment outcome when compared to effects of the rehabilitation program administered alone. Many more of those who received acupuncture as supplemental care were able to return to their previous type of employment.

Coan RM, Wong G, Ku SL, Chan YC, Wang L, Ozer FT and Coan PI{1980)
The acupuncture treatment of low back pain: a randomized controlled study,
Amerj Chin Med 8:181-189

Type of Study: A combined course of manual acupuncture and electroacupuncture was compared to no- treatment (wait-list controls) for alleviation of chronic low-back pain.

Research Design: Fifty patients with chronic low-back pain of multiple etiologies (mean duration 9 years) were randomly assigned to receive acupuncture immediately or to wait 15 weeks before receiving acupuncture treatment. Treatment was administered according to the judgments of the acupuncturists - point selection and treatment protocol were individualized on the basis of diagnosis. Manual and electroacupuncture techniques were used according to need. Pain levels, pain duration, limitation of activity and use of pain medication were assessed at baseline and at 10 and 40 weeks post-treatment for the acupuncture group. The wait-list group was assessed at 15 weeks after the start of the study (baseline for their delayed treatment) and at 25 weeks (10 weeks post-treatment) and 40 weeks.

Results: Treatment groups were comparable at baseline. At 10 weeks post-treatment the acupuncture patients showed 32% decrease in mean hours of pain, 51% decrease in mean pain score, 19% decrease in mean limitation of activity and 33% decrease in pain medication consumption. After 15 weeks of "waiting", the delayed treatment group showed no significant changes in any of these measures. At 25 weeks (10 weeks post-treatment), the delayed treatment group showed improvements in all 4 measures that were comparable to those seen for the immediate treatment group. Improvements were maintained at 40 weeks in both groups.

A distinct treatment effect of acupuncture was demonstrated for chronic low back pain under conditions where acupuncturists provided treatment in a manner consistent with their usual manner of practice.

MacDonald AJR, Macrae KD, Master BR and Rubin AP (1983)
Superficial acupuncture in the relief of chronic low back pain,
Ann Roy Coil Surg Eng 65:44-46

Type of Study: Acupuncture was compared to placebo treatment for alleviation of chronic low-back pain.

Research Design: Seventeen patients with chronic low-back pain of multiple etiologies (over one year duration), and who had failed conventional therapy, were randomly assigned to receive either acupuncture treatment or placebo treatment with a disconnected TENS unit. Acupuncture consisted of the shallow insertion of a variable number of needles at variable points, as determined by palpation for each patient. The duration of treatment was varied and the electrical stimulation was added depending upon the response of the patients. The mock TENS treatment was applied at points selected by the same methods, and for variable duration of treatment depending upon the response of the patients. Patients recorded their daily pain levels during the week prior to each treatment using a visual analogue scale. Pain associated with various activities was also recorded on the day before each treatment using visual analogue scales. The degree of improvement was rated on the day after each treatment on a 0-10 scale. Patient mood, activity, appetite, sleep and anxiety, as well as clinical signs, including gait, mobility, leg raises and reflexes were also assessed before and after treatments.

Results: The 2 treatment groups were comparable at baseline. The acupuncture group improved significantly on most assessments, while the placebo group showed only minimal improvements. These changes were significant for acupuncture compared to placebo treatment for pain relief (77% vs 30%), activity pain score reduction (52% vs 6%), physical signs reduction (97% vs 27%) and severity and pain area reduction (74% vs 19%); the combined average reductions were 71% vs 21%.

These findings demonstrate clear and significant benefits of acupuncture treatment for chronic back pain patients, all of whom had back pain for over a year, and all of whom had failed previous orthodox treatments. This study, in which acupuncture significantly out-performed placebo treatment, supports the use of acupuncture as a method of helping treat and rehabilitate chronic back-pain patients.

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