By James Patrick Murphy, M.D.
As a Pain Specialist, I see people every day with numerous ailments. Most often however, when I ask my patient to focus on the primary source of the pain, the response is usually, “It’s my back!” Back pain is exceedingly common. In fact, only the common cold keeps more people off from work. If an attack of back pain has been ongoing for less than a month, it can be considered “acute.” If it has been ongoing for more than three months it is considered “chronic.” Throughout the course of an “attack” of back pain, people turn to a variety of remedies. These range from doing nothing… to taking anti-inflammatory meds… to massage and physical therapy… to powerful pain killers… to injections… to surgery. Another option that is growing in favor amongst patients is acupuncture.
One can turn to acupuncture at any point in the process. Acupuncture can be helpful with something as simple as a muscle spasm or as complex as an inflamed spinal nerve. Acupuncture can at times be the only therapy necessary, but usually is considered a “complementary” treatment – meaning it is useful in conjunction with other treatments.
Acupuncture has been used for over 4000 years. Almost every ancient civilization has practiced some form of acupuncture. The National Institutes of Health inWashington,D.C.provided a convincing report in 1997 when the panel concluded that acupuncture “may be useful as an adjunct treatment or an acceptable alternative” in treating muscular pain (Acupuncture. NIH Consensus Development Statement, November 3-5, 1997). This NIH consensus paper stands as a legitimate recognition of acupuncture’s therapeutic benefits.
How acupuncture works is still unclear. The Chinese tradition says that energy (“chi” – pronounced chee) courses through the body in much the same way blood travels through vessels. When some unhealthy process such as inflammation blocks the flow of chi, symptoms develop. For example, after an activity like gardening the inflammation in sore back muscles can block chi, just like a clogged artery can cause a heart attack by depriving the heart muscle of oxygen. An acupuncture needle, by penetrating the cellular membranes, aids the flow of energy through the blockage.
A more contemporary explanation is that acupuncture causes the release of naturally occurring pain-fighting substances in the brain (i.e. endorphins, dynorphins, serotonin and other such chemicals) responsible for the well-known “runners high,” which is associated with “feel-good” chemicals in the body. Increased blood flow in the vicinity of the needles delivers more of these pain-fighting substances to the areas where they are most needed.
When an injury has persisted for more than three months it can be categorized as “chronic.” Physical therapy, longer acting pain medications, and “co-analgesics” such as Cymbalta, Lyrica, and Celebrex might be used. Acupuncture can be very valuable in enhancing and directing the body’s own natural “holistic” versions of these medications to the appropriate sites of action.
In many states, licensed acupuncturists can provide treatments. InKentucky, the medical board oversees this activity. Physicians and osteopaths can perform acupuncture themselves or provide coverage for a licensed acupuncturist. Proceed with caution, as there are many who “fly under the radar” by practicing acupuncture outside the bounds of any oversight. Avoiding these unlicensed acupuncturists makes good sense. While generally very safe, acupuncture can cause side effects and have complications that could be dangerous. Seek only the services of someone who has been properly trained and licensed in your state.
Given the often ambiguous and subjective nature of back pain, and the many options now available for care, this is truly an area where treatment can rise to the level of art, and relief can generally be found. Acupuncture is a recognized, legitimate, and effective treatment that can complement any of a number of other remedies.
Dr. James Patrick Murphy is founder and director of Murphy Pain Center and is a clinical professor with the University of Louisville School of Medicine. He was fellowship trained in Pain Medicine at the Mayo Clinic and is board-certified in Pain Medicine and Anesthesiology. He can be reached at (502) 736-3636.