Vol.3 Issue 1
Low Back Pain

GUEST EDITORIAL

TRADITIONAL CHINESE MEDICINE FOR LOW BACK PAIN

Low back pain is one of the most common and costly health problems in the United States. According to the American Chiropractic Association, 31 million Americans experience low back pain at any given time, and the annual cost of treatment is $50 billion (1). Although most cases of low back pain resolve within a few weeks or months, some cases persist and are refractory to conventional Western treatment. For these cases, alternative medical systems may provide some relief.

While chiropractic medicine has become a mainstream medical system for persons seeking relief from low back pain, Traditional Chinese Medicine (TCM) is gaining popularity. TCM for low back pain encompasses several treatments including acupuncture, herbal therapies, heat therapy, nutrition, stretching and exercise, physical manipulation (tuina, sotai, shiatsu), and adjunctive therapies, such as cupping and gua sha.

Although TCM is considered an alternative medical system, many practitioners provide integrative care. For example, most TCM practitioners would recommend that low back pain patients first visit a Western medical doctor to rule out tumor, cancer, osteoporosis, or any other diagnoses that indicate treatment other than those encompassed by TCM. Additionally, Western medical diagnoses and images (x-rays, MRIs) are used in planning TCM treatments. However, unlike Western providers, TCM practitioners are not subjected to the same HMO-imposed time constraints. Thus, they have a greater opportunity to forge patient/provider partnerships in order to maximize adaptive responses to illness and to promote wellness.

Does TCM work for low back pain? Limited evidence suggests that it may. In 1997, the NIH released a consensus statement on acupuncture in which it concluded that “ample clinical experience, supported by some research data, suggests that acupuncture may be a reasonable option for a number of clinical conditions (including) low back pain” (2). In a recent Swedish trial, patients assigned to eight weekly manual acupuncture or electroacupuncture treatments showed significant reductions in pain and increased activity levels compared to patients assigned to mock transcutaneous electrical nerve stimulation (TENS) (3). Additional research is needed to test the effectiveness of TCM as a comprehensive approach, and not just the effectiveness of its constituent therapies.

1. American Chiropractic Association. Retrieved from http://www.amerchiro.org/media/whatis/benefits.shtml

2. Acupuncture: National Institutes of Health Consensus Development Conference Statement, 1997. Retrieved from http://consensus.nih.gov/cons/107/107_statement.htm#7_Conclus

3. Carlsson CP, Sjolund BH. Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clin J Pain 2001;17:296-305.