Did you know that low back pain is the most common reason people visit their doctors each year in the US? Nearly 1/4 of all Americans have experience low back pain in the last three months. Low back pain can reduce productivity, cause people to miss work and have an adverse effect on mood and memory. In the past MD’s have been quick to prescribe a pharmacological ‘fix’ for back pain - which in turn has created an epidemic of opioid addiction. In response to this epidemic , the American College of Physicians (ACP) has released it’s new 2017 Guidelines to Physicians for Acute, SubAcute and Chronic Low Back Pain.
The ACP 2017 recommendations are based upon a systemic review of randomized, controlled research studies. The top recommendations is refer people with acute or subacute low back pain for acupuncture and massage and to avoid a pharmacological approach! Home care may include the application of heat.
For patients with chronic low back pain physicians are being guided to recommend a multidisciplinary approach that includes: acupuncture, exercise (yoga, tai chi, motor control exercise & rehab) as well as progressive relaxation & meditation.
At Yin Rising Acupuncture & Yoga we offer a synergy of acupuncture and bodywork: massage, cupping, TuiNa & more as well as yoga therapy, relaxation and meditation classes to help heal and prevent back pain!
What type of acupuncture is best for different types of back pain? While everyone responds to acupuncture a little differently - and because back pain can be caused by lots of different things - this is a complex answer.
In general, back pain that is mild and mostly due to tension/stress can get relief from Community style or Balance method acupuncture: this style of acupuncture does not place needles directly into the site of pain. Instead points are chosen along meridians that balance the area of pain - usually some distance away from the area of pain. The Balance method approach to acupuncture is similar to the practice of Reflexology, using points far away from the problem of pain. For example, using Li4 (a point on the index finger near the where the thumb meets the hand on the Large Intestine meridian) for headaches. According to meridian theory, Li4 is the Command point of the head, the meridian ends below the nose and is therefore also used for sinus pressure, rhinitis and other nasal problems. The Balance method approach also uses this point for low pain. For example, modern medical research into the effect of acupuncture using MRI brain scans have consistently found that acupuncture at the point: Li4 on the hand
(pictured here) decrease brain activity in the regions associated with pain, the hippocampus and pregenual cingulate. (The same brain regions are also responsible for memory and learning which explains why chronic pain is often associated with cognitive impairment.) Many styles of acupuncture might approach treating low back pain indirectly by only using points that are not on the low back, such as Li4. This is especially common in Community style acupuncture where patients are treated in a group setting. This style of acupuncture can be effective depending on a variety of factors, including the cause of pain, duration of pain, and other health factors including age, nutrition, hydration, stress level, activities, overall fitness level, prior injuries, and more.
For acute and chronic low back pain that is more due to structural problems, misalignments, injury/strain, muscle weakness a more direct acupuncture style that also incorporates some form of massage, bodywork, TuiNa, & cupping may be more effective than Community style acupuncture for some people. Orthopedic acupuncture uses many of the same indirect methods of treating specific areas of pain while also going directly to the site of pain/injury. Acupuncture needles can be used directly at the site of pain for example, to release trigger points or to enhance blood flow and decrease inflammation directly in the region of pain. The insertion of fine acupuncture needles directly at the location of pain activates the body’s own healing mechanisms, including the release of natural opioids, endorphins, anti-inflammation responses. One of the most recent develops in acupuncture research is focusing on how acupuncture increase adenosine up to 24% directly around the area of needle insertion. Adenosine is the A in ATP (our source of energy for everything from muscular contraction to metabolism). Adenosine is also a vasodilator (increase blood flow) and acts an anti-nociceptive (natural analgesic/pain killer) (Goldman, 2010). Regions of chronic pain are often associated a lack of blood flow whether due to muscle tension, joint restriction, or inflammation. Local acupuncture can restore blood flow regions of pain, blood flow brings oxygen and nutrients the body needs to heal.
As the ACP acknowledges, chronic pain benefits from a multidisciplinary approach. At Yin Rising we combine massage with acupuncture to release muscular patterns that misalign the spine and hip, often the cause of nerve compression and pain. We also offer therapeutic yoga classes and teach how to both strengthen and activate weak muscles, how to recruit core muscles and how to safely stretch and relax away tension.
Contact Yin Rising to schedule your acupuncture appointment and get relief from back pain! Not sure which acupuncture approach is best for you? Give us a call and we’ll guide you towards to best type of treatment based on your symptoms.
Goldman, N., Chen, M., Fujita, T., Xu, Q., Peng, W., Liu, W., ... & Chen, J. F. (2010). Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nature neuroscience, 13(7), 883-888.