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Ask an expert - muscles and bones - back / spine - lower back pain

28 questions

Not just advisable, we would say, but probably likely to be beneficial
Although acupuncture has now been accepted by NICE as a legitimate treatment on the NHS for chronic low back pain, the fact is that a great many of the strategies which one can use in Chinese medicine for treating chronic low back pain are just as applicable to the treatment of acute back pain. Although it may not be popularly recognised a great many people come to acupuncturists as their first choice for acute back problems, and it is far from everyone who goes straight to an osteopath.
Without delving too much into Chinese medical theory, a great deal of chronic low back pain arises as a consequence of the causes of an acute pain transforming over time into what the Chinese would cause stagnation in the channels on the lower back. Treatment is often aimed at moving or unblocking this stagnation and reestablishing a good flow of energy in the area, because it is often the blockage which is said to cause the pain. Clearly if someone can treat the area before the acute trauma has consolidated into something more fixed, there is more chance of moving the short term problem and reducing the longer term problem. Getting research to validate this would prove difficult - getting dozens of patients in the same area with exactly the same acute problems would prove difficult in the West - but it is standard practice in many outpatient departments in Chinese hospitals to have a course of ten acupuncture treatments daily after an acute episode to ensure that the area is moblised again as quickly as possible.
The vital thing with acute back pain, however, is to ensure that there is no physical damage to the vertebrae or the discs, and no misalignment which if left untreated by conventional medicine could make the situation worse. It would also be vital to rule out any underlying physiological problem; gall bladder problems and kidney problems, for example, can manifest in such a way that the pain feels as though it is in the tissue of the back. It is always best to start with your GP, as we are sure you have, and then perhaps seek the advice of an osteopath if your pains started after a particular movement or injury. We are sure that a BAcC member will guide you carefully through this process if you seek their advice, and most are more than happy to spend a little time without charging giving you a better assessment based on a face to face chat of your options. 

Q:  I have an exposed nerve in my lower back due to wear in my lower spine. I have been told I need a spinal steroid injection which I dont want. Could acupuncture give me any relief?


A:  Spinal steroid injections can be helpful for some groups of patients while offering limited benefit to others. As this study shows
there is no doubt that it can help, but a great deal depends on the extent of the deterioration and where its exact location is.
Acupuncture treatment can have some very positive benefits for lower back pain and for sciatica, as our factsheets show please click here

and please click here

and as we are sure you are aware it is now amongst the recommended treatments in the NICE guidelines for lower back pain. However, there are limits to what any form of treatment can achieve in the face of extreme deterioration of a spinal joint, and you would almost certainly need to be assessed face to face by a practitioner for them to be able to give you an informed professional view on whether they could help you.
It is important to be aware, however, that Chinese medicine as a system operates on an entirely different basis from conventional medicine, using concepts such as 'qi', a description of the energy of the body, and of flow of energy around the body. The practitioner will want to know not simply where things hurt now, but how the whole system is working and why the back has deteriorated in the way it has, along with what other symptoms you nay have. All of this information will help them to build up a comprehensive picture of your system and give you the best possible advice on the advisability of acupuncture treatment.   

Q:  Hi I have had back pain for nearly 5 years, after I had flu injection, that night I could not walk. I was sent to A E by my doctor. There I was given a pill and left to sleep. I was  sent home  in a wheel chair. My doctor requested  a MRI. I had a small trapped nerve for which I now take more and more pills. I have had pain treatment which gave me 3-4 week free. this was nice, I was given  a tens machine. On using this I had a pain down my spine to my feet.  I  collapsed  it was like cramp. The doctor sent me to A E for a DVT and after 1 week of treatment it was not. It  was a nerve problem. The last 8 weeks have been hard and the pain is worse. I am on a morphine based tablet with another bunch.  The  last MRI showed no damage to lower spine l-5 l-4 l-3.   Is there any chance that acupuncture, could help me this time


A:  Generally speaking the advice which we give to people suffering from back pain is straightforward. As our factsheet shows please click here

there is a considerable volume of research suggesting that acupuncture can help with chronic low back pain, such that NICE now make it one of the recommended options for treatment.
However, it seems as though something else has happened in your case, and the question which a practitioner would have to resolve would be how much the flu injection was causally connected to the sudden escalation of your problem, and if not, what else might have been going on which could have caused the pain and restriction of movement to have increased so much. Back pain is used as a generic term in both eastern and western medicine to cover an enormous variety of specific causes and types of pain. Just as the conventional doctors have tried to elicit by elimination what is causing your continuing problems a practitioner of Chinese medicine would want to try to establish how to classify your symptoms within the diagnostic patterns of Chinese medicine, and then make sense of how some of the interventions appear to have made things worse.
Your case has such specific factors that it is difficult to give unequivocal advice, but based on the recognised role of acupuncture in the treatment of low back pain we can say with confidence that it would be worth your while visiting a BAcC member local to you for them to be able to give you face to face assessment of whether they think that acupuncture will benefit you. Of concern, though, will be your reaction to TENS. Although these machines are much more vigorous than acupuncture treatment they often use similar areas of the body for treatment, and the practitioner will want to check whether your system has become hyper-sensitive to some forms of treatment, which can happen when pain becomes constant and debilitating.

Q:  I have low back pain mainly on both sides but the right is much worse on the buttock and toes down to both the outside of my upper and loser legs and my feet feel very tight and and burnign.  I have had 6 acupuncture sessions so far can I expectr better results by having more acupuncture. 


A:  It is very difficult to give you an accurate answer. So much depends on how long you have had the pain, what physical damage there may have been to cause the initial onset of the pain, and what other treatments may have been tried.
All that we can advise is that you discuss with your practitioner what progress they believe has been made, what their own estimate of the prognosis is, and what review periods they think are essential to ensure that you do not have treatment which is not having any useful or sustained effect. We have to be realistic in our work and emphasise that not all problems respond to treatment, and in some cases where the problems do respond the effect does not last. In cases such as these the practitioner may well have other suggestions or recommendations about other forms of treatment which may be better suited to the problem or the person.  

A: There is no reason not to undertake treatment as soon as possible after an injury to the lower back or the manifestation of a lower back problem. In Chinese hospitals it is routine practice to use courses of acupuncture daily as soon as possible to ensure that the blockages and after-effects of the initial problem do not consolidate into a longer-term chronic problem which becomes all the more difficult to shift.
We are not quite clear from your question what the extent of your problem is and what treatment you may already be having or have had for it. We are confident, however, that if you visit a BAcC member local to you for advice and potentially for treatment they will ensure that there is nothing in your unique circumstances which would make the use of acupuncture inadvisable. Factors which they might take into account would be any surgery you may have had and any advice from you GP or consultant. If they had any doubt about proceeding they would almost certainly, with your permission obviously, contact your GP to ensure that there was no contra-indication to the use of acupuncture.
We suspect that this would be unlikely, however. Many members see a large number of patients with lower back and disc problems, and acupuncture is even recommended in the NICE guidelines for the treatment of chronic back pain.

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