Treatment of Low Back Pain with Acupuncture - the American Recommendations

Following on from the negativity for Acupuncture as a Treatment for Low Back Pain in the current UK NICE guidelines, our American Colleagues have taken a completely opposite view on this matter and recommend Acupuncture as a non-pharmacological therapy for Acute and Subacute Low Back Pain.

According to the published guidelines in the Annals of Internal Medicine: referring to Non-invasive Treatments for Acute, Sub-Acute, and Chronic Low Back Pain:

“Recommendation 1:

  • Given that most patients with acute or sub-acute low back pain improve over time regardless of treatment, clinicians and patients should select non-pharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). If pharmacologic treatment is desired, clinicians and patients should select non-steroidal anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence). (Grade: strong recommendation)”

“Recommendation 2:

  • For patients with chronic low back pain, clinicians and patients should initially select non-pharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioural therapy, or spinal manipulation (low-quality evidence). (Grade: strong recommendation)”

For acute, sub-acute and chronic low back pain, I find clinically a combination of the various treatments modalities and approaches mentioned above most effective. My choice of techniques depends on patient expectations and preferences combined with my clinical experience and recommendations allowing for highly individualised care.

By Simon.

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