February 6, 2016

Back Pain & Acupuncture

Back pain is chief among the chronic pain issues that cause daily suffering for millions. The Institute of Medicine of The National Academies estimates that at least 100 million people in the U.S. experience chronic pain (1). Approximately 1/3 of those suffer from chronic back pain.

Lowered Quality of Life

Back pain seriously erodes the quality of life. It is the leading cause of disability for Americans under the age of 45 (2). Even when the impact of back pain stops short of total disability, there are profound effects. For example, chronic back pain is related to greater incidences of poor physical and mental health. People with low back pain are 3x more likely to be in fair or poor health and more than 4x as likely to experience serious psychological distress than those without it (3). The limitations within daily routines and activities can be dramatic.

The Healthcare Dilemma

Healthcare providers have long struggled with how best to treat patients with chronic back pain. Primary difficulties are how to provide substantial relief, improve their patients’ quality of life and minimize the risks of addiction to painkillers while doing so. These are not easy problems to resolve. Long-term treatment for pain management has several inherent hazards such as the addictive nature of many medications and the potential for developing drug tolerance and drug dependency.

Drug Tolerance and Risks

Drug tolerance is the body’s need for increasing doses of a drug over time to achieve the same desired effects. This means that if relief is achieved let’s say with x milligrams today, in some months, one is apt to require more than x just to maintain that initial level of relief.  The unfortunate thing is that this process does not top out for many people. The longer one takes the medication, the more likelihood of the dose needing to increase to give the same relief that was initially felt. Of course, the body is eventually not able to tolerate such increases.

Drug tolerance is a cardinal characteristic of drug abuse and addiction. Developing a physiological tolerance is not simply an addiction issue, however. It is usual medical practice to help patients gradually increase to therapeutic dosing so that the body grows in its tolerance and health risks are minimized. A hefty dose of many medications, even if medically indicated as optimally beneficial, cannot be given right away, for example, because the body could not safety accommodate it. What would be an overdose initially is a therapeutic dose after gradual increases are made. Of course, maintaining that balance is the problem over the longer term. Physiological tolerance in medical practice is also why many medications cannot be stopped abruptly, but have to be gradually decreased.

Addiction issues come into play when the body has physiological dependence but also misuse of medication is done in order to meet the body’s growing need for the drug. Also, in the addictive process, psychological dependency is in play. Misuse of the drug is needed for psychological factors such as the ability to cope with emotions or stressors. Of course, not everyone using pain medications will develop an addiction. Estimates vary widely about how many will.

We do know some alarming facts about addiction and the relationship to prescription medication, however, which can illuminate the addiction risks. For example, the Centers for Disease Control and Prevention have stated that people addicted to prescription painkillers are 40 times more likely to use heroin (4).

This is not to say that pain management clients will become addicted to heroin! However, it does demonstrate the severe addiction risks involved for some that take prescription painkillers. That statistic is taken from studies of those already heroin addicted. They showed overwhelming evidence of how addiction to prescription pain medications can progress. Keep in mind that the figure reflects people who were using pain medications as part of an addictive process. Nonetheless, another alarming fact is that many people progress to painkiller misuse and addiction from legitimate medically supervised uses of prescription painkillers.

Integrated Care

Many efforts are made in medical practice to mitigate the risk of addiction. Additionally, pain medications are essential in compassionate and merciful care of countless individuals. Often, the best care is an integrated approach using many strategies. Such treatment plans can help reduce the amount of medications needed. There is a great deal of research documenting the effectiveness of acupuncture in pain control. Here are some highlights. You can find more on our posts:

Acupuncture has proven to be an effective way to help manage pain without increasing the risks of addiction. In some cases, it can reduce the need for addictive medications (5). 

 “I think the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication,” says Dr. Lucy Chen, a board-certified anesthesiologist, specialist in pain medicine, and practicing acupuncturist at Harvard-affiliated Massachusetts General Hospital (6). 

We conclude that acupuncture could provide immediate effect in reducing pain of acute low back pain significantly. The results from this study provide clinical evidence on the efficacy and safety of acupuncture to treat acute low back pain in the emergency department (7).

acupuncture as an adjunct to conventional therapy provides short-term clinically relevant improvements in pain and functional measures for the treatment of chronic low back pain (8).  

If you are in the Louisville area and are interested in Louisville acupunctureacupuncture for the treatment of back pain, you can contact Jeffrey Russell in his clinic, Abacus Chinese Medicine, at 502 299-8900.

Some of our other posts you may be interested in:

Acupuncture Lessens Pain

Works Cited
1. Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press, 2011.
2. National Centers for Health Statistics, Chartbook on Trends in the Health of Americans 2006, Special Feature: Pain.
3. National Centers for Health Statistics, Chartbook on Trends in the Health of Americans 2006, Special Feature: Pain.
4. https://www.cdc.gov/media/releases/2015/p0707-heroin-epidemic.html
5. Yuan, Purepong, Kerr, Park, Bradbury, McDonough. Effectiveness of acupuncture for low back pain: a systematic review. Spine (Phila Pa 1976). 2008 Nov 1;33(23).
6. https://www.health.harvard.edu/blog/acupuncture-is-worth-a-try-for-chronic-pain-201304016042
7. Chiu, Chang, Lee, Chen, Chang, Lee, Lo. Efficacy and Safety of Acupuncture for Acute Low Back Pain in Emergency Department: A Pilot Cohort Study. Evidence-Based Complementary and Alternative Medicine Volume 2015 (2015),
8. Liu, Skinner, McDonough, Mabire, Baxter. Acupuncture for Low Back Pain: An Overview of Systematic Reviews. Evidence-Based Complementary and Alternative Medicine.
Volume 2015.