BACK STABBING Acupuncture has been recognized effective against low-back pain for 3,000 years
By Mabelle Aban, Contributing Writer
Common among people of all ages, low-back pain can be triggered by a wide variety of conditions, among them, injury or overuse of muscles, ligaments, or joints; pressure on nerve roots, herniated disc, osteoarthritis, spondylosis, and fractures. Pain may be acute or chronic, and is commonly managed using appropriate medicines. However, there are also existing alternative methods of treatment that can possibly complement pharmacologic treatment. One of these is acupuncture, a form of traditional Chinese medicine that has been practiced for over 3,000 years now. It involves inserting and manipulating needles into points on the body with the aim of restoring health and well-being. Dr. Teresita Chu-Uy, an acupuncturist with the Physicare Medical Clinic and Manila Doctors Pain Management and Wellness Center, notes that 80 percent of the population worldwide suffer from low-back pain. "At least 90 percent experience low-back pain at least once in their lives," she says, noting that this phenomenon can be associated with the spine being inherently weak in the low-back area. According to Chu-Uy, acupuncture can offer relief from low-back pain due to spasms, strains, and myalgia. But acupuncture alone cannot totally treat arthritis and structural problems; it just complements the treatment to aid the healing process, she points out. How acupuncture treats conditions such as low-back pain can be explained by several theories, of which Chu-Uy cites three. First is the gate-control theory, which explains how a certain stimulus activates nonnociceptive nerves that can inhibit pain. "The gate closes, so the transmission of pain can be blocked," Chu-Uy says. However, this theory can't explain it all, especially the aspect of continued relief from pain or the lasting effect of this treatment. Then there is the channel theory, which says that with improved circulation, pain mediators can be washed out. The last theory is the chemical-mediator theory, which describes acupuncture as a starter that initiates the body to produce endorphin. "This endorphin is just like morphine but it's naturally present and is being produced in the body," explains Chu-Uy. "That's why they say, to get more effect, a person should not take a pain killer." Chu-Uy says that in many patients, there is already marked relief after the first session, but in general, it would take about four to six sessions to see significant improvements. For acute pain, she said four sessions would do. Contraindications for acupuncture include hemophilia and the presence of wound or skin infection on the acupuncture point. Though not absolute, another contraindication is needle phobia. Chu-Uy notes, however, that some of her patients were able to overcome their phobia. For those who are quite overwhelmed with the idea of getting pricked by needles all over their body, Chu-Uy usually asks them if they have been injected before, because injections are about 10 times more painful. Pain is very minimal as the needle used in acupuncture is a very fine one, almost the size of the diameter of the hair, and the needle is pliable. For those who may be concerned about the adverse events following a session, "there is no side effect, as long as you really use proper technique, proper aseptic method, and you have to be well trained," Chu-Uy says. The Philippine Institute of Traditional and Alternative Health Care (PITAHC) of the Department of Health also actively promotes the use of acupuncture as a part of an integrative and natural approach to health care. Dr. Francis Ras, an acupuncturist and the PITAHC head of training, points out: "It is part of the management, it complements, it can cure. Especially if it's the muscle, it's very effective." And there is growing scientific evidence to its effectiveness. A Cochrane review in 2005 revealed that "when acupuncture is added to other conventional therapies, it relieves pain and improves function better than the conventional therapies alone." Meanwhile, a review for the American Pain Society/American College of Physicians found evidence that acupuncture is effective for chronic low-back pain. In the training sessions he supervises, Ras stresses that the cause of the low-back pain must first be identified, so that any anatomical problem may be ruled out. "Because in acupuncture, you only manage pain," he points out, citing as example muscle pain of the low back, "which is symptomatic, not anatomical." If it's an anatomical problem, like a slipped disc, he would refer the patient first to a specialist. Similarly, the number of sessions that he suggests is between five and 10 depending on chronicity. Ras says he is happy about the growing acceptance of acupuncture among Filipinos, citing that it is now included as part of the comanagement for physical medicine and rehabilitation. At present, the PITAHC conducts three-week basic training on acupuncture for doctors who want to practice acupuncture. Eventually, the PITAHC has plans of training other health professionals, as well as establishing a certification body for the practice. M
WASHINGTON Acupuncture could prove more effective than conventional treatment in curing back pain, according to a new study. "Low-back pain is a common, impairing, and disabling condition, often long-term, with an estimated lifetime prevalence of 70 to 85 percent," wrote Dr. Michael Haake, one of the study's coauthors, in the Archives of Internal Medicine. "Acupuncture gives physicians a promising and effective treatment option for chronic low-back pain, with few adverse effects or contraindications," he said, noting that back pain was one of the key reasons for work absences and disability. Haake and his colleagues carried out a clinical trial of some 1,162 patients, with an average age of 50, who had suffered from back pain around eight years, at the University of Regensburg, Germany. In a random selection, a third of the group were given 10 30-minute acupuncture sessions at a rate of about two a week based on traditional Chinese medicine, with the needles inserted between five and 40 millimeters under the skin. Another third, 387 patients, were given sham acupuncture, with the needles only implanted one to three millimeters. The final group was given conventional therapy of medication, physical therapy, and exercise. After six months, 47.6 percent of those receiving Chinese acupuncture had noticed an improvement in their condition, along with 44.2 percent in the sham group. Only 27.4 percent of the group receiving conventional therapy, however, reported any improvement, noted the study. "The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals, or processing of pain signals by the central nervous system and that is stronger than the action mechanism of conventional therapy," the authors said. The effects of the acupuncture also lasted beyond treatment, the study concluded M AFP |
