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Acupuncture effective for back pain and migraine

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Research shows that acupuncture can be an effective form of treatment for patients with lower back pain or migraine. This is reflected in a growing number of (Western) medical guidelines recommending acupuncture as an effective treatment for chronic lower back pain and migraine.

Research
Acupuncture to combat pain is effective in 76 percent of cases [1]. Recent large meta-analyses support these results and show that a series of acupuncture sessions is a meaningful treatment option for patients with chronic (lower back) pain [2]. On average, it becomes clear within two to four sessions whether the treatment is effective. The effects of the treatments last long, as The Journal of Pain writes that after a year, the achieved effect of acupuncture treatments has decreased by only 15 percent [3].
The independent research institute Cochrane writes in a review that the available studies seem to indicate that acupuncture in the treatment of migraine is at least as effective as prophylactic drugs and as such offers a possible treatment option for migraine patients [4].

Side effects 
Unlike some other treatment methods, acupuncture has hardly any side effects. If they do occur, they are usually minor, such as bruising and/or temporary fatigue.
Research shows that out of nearly 4.5 million treatments, 11 serious complaints have been reported [5]. A summary of various studies on the safety of acupuncture can be found on the Evidence Based Acupuncture website. It shows that acupuncture is a safe treatment method, provided it is performed by a well-trained acupuncturist [6].

Medical guidelines
In the Netherlands, acupuncture for pain relief in low back pain is only mentioned in the Pain Guideline of the Association of Elderly Care Physicians and Social Geriatricians (Verenso) [7]. In contrast, in English-language medical treatment guidelines, acupuncture has been mentioned positively nearly 1500 times in recent years, for both acute and chronic pain [8].

For chronic low back pain
The American College of Physicians (ACP), for example, advises to 'initially choose a non-pharmacological treatment with exercise, multidisciplinary rehabilitation, acupuncture, and mindfulness-based stress reduction' [9].
The North American Spine Society (NASS) recommends adding acupuncture to usual care for short-term pain and function improvement [10]. The Scottish National Clinical Guideline for the Management of Chronic Pain aligns with this recommendation [11], and the renowned British National Institute for Health and Care Excellence (NICE) has included acupuncture in its Chronic pain guideline [12].

For the treatment of tension headache and migraine with aura where topiramate and propranolol are not effective, NICE recommends up to ten acupuncture sessions over 5 to 8 weeks [13]. Cochrane mentions in its systematic review that acupuncture can be considered as a treatment option for patients willing to undergo this treatment [4].

KNMG Guideline
The KNMG Physicians' Federation is open to non-conventional treatments, provided they meet four conditions [14]. Given the available scientific research and clinical experiences regarding the effectiveness of acupuncture for chronic low back pain or migraine, without neglecting conventional indicated treatments, a patient, in accordance with their wishes and supplemented with good information, can be referred to acupuncture as a possible and safe treatment option.

References:

  • 1. Weidenhammer, W., et al, Acupuncture for chronic pain within the research program of 10 German Health Insurance Funds--basic results from an observational study, Journal of Complementary Therapies in Medicine, 2007 Dec;15(4):238-46.
    https://pubmed.ncbi.nlm.nih.go... [←]

  • 2.  Vickers A.J. et al, Acupuncture for Chronic Pain, Individual Patient Data Meta-analysis, Archives of Internal Medicine, 2012, Oct 22; Vol172,No.19:1444-53
    https://pubmed.ncbi.nlm.nih.go... [←]
                                  

  • 3. Vickers A.J. et al, Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain, 2018, May,Vol 19,No.5, 455-474; Epub 2017 Dec
    https://pubmed.ncbi.nlm.nih.go...    [←]

  • 7. Verenso. Multidisciplinary Guideline Pain, Recognition and treatment of pain in vulnerable elderly. Part 1 - summary, Part 2 - integral text, Part 3 - annex, Utrecht: Verenso 2011 https://www.verenso.nl/_asset/...[←]

  • 8. Birch, S., et al, Overview of Treatment Guidelines and Clinical Practical Guidelines That Recommend the Use of Acupuncture: a Bibliometric Analysis, The Journal of Alternative and Complementary Medicine, Vol 24, No 8, 2018 (Aug), pp. 1-18
    https://www.liebertpub.com/doi...    [←]

  • 9. American College of Physicians (ACP), Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline, ACP Journals/Annals of Internal Medicine, 2017 (April) https://www.acpjournals.org/do...[←]

  • 10. North American Spine Society (NASS), Diagnosis and Treatment of Low Back Pain, Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care, NASS, 2020
    https://www.spine.org/Portals/...    [←]

  • 13. National Institute for Health and Care Excellence (NICE), Headaches in over 12s: diagnosis and management, NICE Clinical guideline [CG150], 2012 (Sept), Updated 2021 (May) https://www.nice.org.uk/guidan...[←]

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