This evidence-based systematic review will focus on the use of acupuncture and its role in the treatment of low back pain to help better guide physicians in their practice. It will cover the background and the burden of low back pain and present the current options for treatment and weigh the evidence that is available to support acupuncture as a treatment modality for low back pain.
Low back pain (LBP), defined as a disorder of the lumbosacral spine and categorized as acute, subacute, or chronic, can be a debilitating condition for many patients. Chronic LBP is more typically defined by its chronicity with pain persisting > 12 weeks in duration. Conventional treatment for chronic LBP includes both pharmacologic and non-pharmacologic options. First-line pharmacologic therapy involves the use of NSAIDs, then SNRI/TCA/skeletal muscle relaxants, and antiepileptics. Surgery is usually not recommended for chronic non-specific LBP patients. According to the 2016 CDC Guidelines for Prescribing Opioids for Chronic Pain and the 2017 American College of Physicians (ACP) clinical practice guidelines for chronic pain, non-pharmacologic interventions, acupuncture can be a first-line treatment for patients suffering from chronic low back pain.
Many studies have been done, and most show promising results for acupuncture as an alternative treatment for low back pain. Due to non-standardized methods for acupuncture with many variations, standardization remains a challenge.
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Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA
Ivan Urits & Amnon A. Berger
Department of Anesthesiology, LSUHSC School of Medicine, Shreveport, LA, USA
Ivan Urits, Alan D. Kaye & Omar Viswanath
Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
Jeffrey Kway Wang, Kristina Yancey, Mohammad Mousa & Omar Viswanath
MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC, USA
Jai Won Jung
Department of Anesthesiology, Ain Shams University, Cairo, Egypt
Islam Mohammad Shehata
Department of Anesthesiology, Desert Regional Medical Center, Palm Springs, CA, USA
Amir Elhassan
Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
Omar Viswanath
Valley Pain Consultants – Envision Physician Services, Phoenix, AZ, USA
Omar Viswanath
Correspondence to Omar Viswanath.