Many of our patients seek acupuncture care for their back pain. 90% of all people have back pain at some point in their lives. 50% of working adults experience back pain every year. It is one of the most common causes of doctor’s visits, and it is the leading cause of disability worldwide.
Back pain can have a seriously negative effect on your quality of life. It can consume all of your attention and make it difficult to work, concentrate, sleep, and take care of basic daily activities. Fortunately, acupuncture is a safe and effective strategy for treating many types of back pain.
Red Flag – Low back pain is rarely a medical emergency. However, if you are experiencing severe low back pain with bowel or bladder incontinence, stop reading this and seek immediate medical attention. This could be a sign of cauda equina syndrome, a potentially life-threatening condition.
Types of Back Pain
Back pain is usually caused by structural or functional problems of the muscles, nerves, spine, or joints. Back pain may be acute (sudden) or chronic (lasting three months or more).
Acute back strain is the most common cause of sudden, severe low back pain. Patients often describe a “deep ache,” feeling “locked up,” or will say, “My back went out.” The pain is usually worse with bending over, and in severe cases the patient may not be able to stand upright. Acute back strain often responds very quickly to acupuncture care and associated treatment modalities. In our experience, acupuncture should be the first line of treatment for acute back strain.
Sciatica / Disc Herniation / Piriformis Syndrome
Sciatica is another very common form of pain. However, in many cases, the patient may not actually feel much pain in the low back. Sciatic pain is usually characterized by sharp, shooting pain that begins in the low back, buttock, or hip and radiates down one or both legs. The pain is caused by a compression of the sciatic nerve. This compression is usually (but not always) caused by a disc herniation or tension of the piriformis muscle.
Disc herniation occurs when a disc in the lower spine “bulges” and touches the sciatic nerve — activating it and sending a painful signal throughout the buttock and leg.
Piriformis syndrome occurs when the piriformis muscle, which lies below the gluteal muscles shortens or spasms and entraps the sciatic nerve.
Acupuncture is a very effective treatment option for sciatica due to its ability to reduce inflammation and inhibit pain signals. Sciatica due to piriformis syndrome tends to respond more quickly to acupuncture. For many people, acupuncture is an effective way to manage sciatic pain from disc herniation, but the healing process can take much more time.
Other Types of Back Pain
The types of back pain mentioned above are by far the most common. However, back pain may be caused by many other conditions such as spondylolisthesis, spinal stenosis, degenerative disc disease, ankylosing spondylitis, and others. In cases where the origin of the pain is structural (rather than functional), acupuncture may be a very useful pain management strategy, but it is unlikely to cure the underlying problem. In cases like these, we focus on relieving as much pain as we can for as long as possible in order to minimize the need for pain medication and to delay the need for surgery.
Acupuncture and Back Pain
When treating back pain with acupuncture, we have two major goals. The first is to relieve the pain as quickly and efficiently as possible so that you can function day-to-day with as little pain as possible. The second goal (when achievable) is to help your body to heal the underlying cause of the pain in order to eliminate or decrease the chances of a future recurrence.
Our key success indicators are decreases in the frequency, severity, and duration of the pain. If your pain is constant, we’ll work together to lessen the severity of the pain and then strive to make any flares less frequent and shorter in duration. On a 0-10 pain scale, we want to get you to a “0” and help you stay there as long as possible.
Because acupuncture addresses and influences the function of the body (rather than the structure), we tend to be most helpful when the cause of the pain is unknown or unclear.
How does acupuncture treat back pain?
We gently insert hair-thin needles into very specific points on the body — in this case typically in the low back, legs and ankles — to stimulate blood flow to the areas of pain in order to bring nourishment (oxygen and nutrients) to the damaged tissues. Acupuncture also reduces inflammation, and in many people it promotes the release of endorphins (“endogenous morphine”) — the body’s own natural painkiller.
Some patients will experience an immediate improvement in their level of pain, but for most, the effect is experienced about 4-24 hours after the treatment. In the beginning, pain relief may last anywhere from a few hours to a few days. However, the results of acupuncture tend to be cumulative, so over the course of a treatment plan we look for lower levels of pain for longer periods of time.
Other Treatment Options for Back Pain
Many patients who visit an MD for back pain will be prescribed pain medication such as Vicodin, Norco, naproxen, or ibuprofen. If the doctor suspects that the cause is muscular, she might prescribe a muscle relaxant such as Flexeril or Soma. In some cases, medications can provide quick relief from debilitating pain. We feel that appropriate use of pain medication can help patients to make it through the day when pain would otherwise stop them from daily activities.
However, pain medications do have their drawbacks. They can be difficult on the digestive system and cause upset stomach or constipation. Opioid-based drugs such as Vicodin and Norco can be highly addictive, and many patients will build up a tolerance over time that requires a higher dose to achieve the same (or less) pain relief. Finally, drugs that block pain signals can encourage back pain sufferers to do more strenuous activity than they are ready for, which may cause more flares and increase the time it takes to heal.
Chiropractic addresses structural imbalances in the spine and can be an effective treatment method for many types of back pain. Since acupuncture is best at treating functional problems, acupuncture and chiropractic can be used together to treat many types back pain with greater efficiency than using one or the other.
Surgery should always be considered as a last-resort option for treating back pain. If the cause of the pain is clear from imaging (e.g. MRI), a skilled surgeon may be able to manually correct the problem. We’ve heard of cases where patients were quickly and immediately cured by surgery, and we’ve heard many more where the surgery did not fix the problem and may have resulted in more or different pain.
Acupuncture may be used to treat pain and stress pre- and post-surgery.
Acupuncture Treatment Planning
We treat every patient as a unique individual, which means that your treatment plan will be customized to your circumstances. Generally, we will ask you to come in 2-3x/week for 2-3 weeks to gauge your body’s response to acupuncture. For some patients, especially those experiencing acute back strain, the initial treatment plan may be all that is required to resolve the pain. For others, especially those with sciatic pain due to a herniated disc, we will continue with care 1-2x/week and then every other week as you are feeling better for longer periods of time between treatments.
If we are not seeing noticeable improvement within the first 3-5 visits, we will release you from care and offer any referrals that may be more helpful. We will not encourage you to continue care unless we truly believe it is in your best interest.
Cost and Insurance Coverage
Almost all insurance that covers acupuncture will cover acupuncture for the treatment of back pain. For more information and to have us check your benefits, see our page on insurance coverage.
If your health insurance policy does not cover acupuncture treatment, we will work with you to keep your care as affordable as possible. Patients without insurance coverage may take advantage of our time-of-service discount. We also offer even lower rates for patients who prepay for their treatment plan. Please see our fees page for more details.