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Lower back pain without a known cause: What works?

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By Saima Anto, M.A., R.AC, R.TCMP

A man is having sore low back

Lower back pain is very common, affecting half of the population every year, and sixty to ninety percent of the adult population is at risk of developing lower back pain. Most often, tests can find no cause for the pain; this condition is termed ‘non-specific’ back pain.

Though most acute episodes will resolve within six weeks, the pain often returns, and ten to twenty percent of lower back pain sufferers go on to experience chronic lower back pain, which persists for at least three months. Non-specific lower back pain is a major cause of missed work hours.

RELATED: Cause and Treatment of Back and Disc Injuries

What works for this type of back pain? That is, what measures are consistently proven to deliver better outcomes than no treatment?

When one high-quality study shows a form of treatment is effective for relieving pain and helping restore function, those findings get our attention. When repeated high-quality studies show a form of treatment works well to relieve pain and help restore function, we can be that much more confident that treatment will deliver results.

For example, one systematic review of randomized controlled trials examining the efficacy of traditional acupuncture, published in the journal Spine in 2013, showed that acupuncture consistently reduced pain and improved function, when used alone or in addition to other approaches.

As the evidence keeps adding up, treatment guidelines now recommend the use of acupuncture as a stand-alone approach, able to treat the majority of back pain cases by itself (though some cases will benefit still more from conjoint treatment, with physiotherapy or chiropractic in addition to acupuncture). The most recent guidelines for treatment of back pain, issued to doctors by the American College of Physicians and the American Pain Society, explicitly states acupuncture has “proven benefits” for patients who don’t get better with self-care.

Some treatment approaches for back pain that are proven to work well — that is, have measurably large effects in repeated studies — include:

–    Acupuncture

–    Behavioral changes

–    Chiropractic

–    Exercise therapy

–    Individualized patient education

–    Massage

–    Physiotherapy

–    Yoga

 

Behavioral changes can make just as big a difference as any of these other measures in relieving pain and restoring function, but are especially important in the acute stage. When back pain interferes with daily activities, it’s important to:

–     Stay active, and get back to normal activities as soon as possible

–    Avoid worry

–    Develop strategies to manage the effects of soreness on daily activities

–    Avoid strains and manage the risks of future injury

 

Patients who receive individualized information covering these points, in sessions lasting at least 2 hours, see better results; however, this effect is stronger for those with acute back pain. Once the pain becomes chronic, these behavioural changes make much less difference.

 

What can I expect when I see an acupuncturist for non-specific low back pain?  Studies show acupuncture treatment offers immediate pain relief and overall improvement in functioning, with effects lasting as long as 3 months after treatment ends.

When you see a licensed acupuncturist for back pain, you may be asked questions that seem unrelated to your back, and the acupuncturist may take your pulse and look at your tongue, as well as asking questions. This just means the acupuncturist will be treating your back pain, not someone else’s. Because the theory underlying acupuncture is holistic and comprehensive, a seemingly random assortment of unrelated symptoms can often resolve into a clear clinical picture when seen through the lens of traditional Chinese or Japanese medical knowledge.

On the basis of traditional medical theory, the acupuncturist may even place some needles in locations that are nowhere near the area where pain is felt; one well-known point for low back issues is actually in the crease of the knee!

Regardless of which particular points are used, you can rest assured knowing that acupuncture based in traditional theory has proven unbeaten as an effective stand-alone treatment for back pain and its related issues.

What kind of treatment makes the biggest difference?  Do something about it, instead of doing nothing. That makes the biggest difference of all.

 

Saima Anto, M.A., R.AC, R.TCMP is available for acupuncture treatments of low back pain and other conditions at Pacific Wellness on Tuesdays, Wednesdays, Fridays and Saturdays.  Please call 416-929-6958 to inquire about the appointment.

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