Lumbar pain, defined as pain and discomfort located in the lumbosacral region with or without irradiation to the leg, is one of the most frequent reasons for consultation and one of the most common symptoms in the general population. It is estimated that more than 70% of adults in industrialized countries suffer from low back pain at some time in their lives.
Although there is a considerable variety of therapeutic alternatives available for the treatment of low back pain (medications, physical therapy, spinal manipulation, etc.), no modality seems to be superior to the others and it is not possible to recommend a single treatment modality, requiring in most cases, the combination of pharmacological treatment and physical therapy, with generally unsatisfactory results in terms of pain control and improvement of function. Consequently patients, often dissatisfied with medical conventional approaches, and seeking to find some more effective therapeutic methods, try complementary or alternative medicine to manage their symptoms, with acupuncture being one of the most popular options.
Acupunture
Manual Acupuncture is the original form of acupuncture practiced by doctors of Traditional Chinese Medicine (TCM) and is carried out by manually twisting the acupuncture needles at various speeds and in different directions, each of these movements means a different therapeutic goal. Electroacupuncture refers to the application of electrical impulses of direct current to the needles through a special machine (the same as that used in transcutaneous electrical nerve stimulation) instead of using manual stimulation.
Therapy with electro-acupuncture in order to optimize traditional western medical treatment has achieved improvement in chronic low back pain and functional disability of patients. Electroacupuncture therapy combines original acupuncture with electrical energy to reinforce its effect, this form of therapy became popular after 1970.
The analgesic effect of electroacupuncture has been shown to be due to the release of endogenous opioid peptides and the activation of descending inhibitory pathways in the central nervous system (CNS).
In a recent study after eight weeks of treatment the researchers found that all forms of acupuncture (individualised, standardised, simulated) reduced back-related dysfunction compared with usual care (acupuncture reduced score by about 4.5 points and usual care by 2.1 points on a 23-point scale). There was no statistically significant difference between the three acupuncture groups. There was little change in scores between eight and 52 weeks, with no difference between the acupuncture groups, and the usual care group continuing to have worse dysfunction than the acupuncture groups.
