Health Problem: Approximately 70% of people in developed countries experience lower back pain (LBP) during their lives, and it becomes chronic in an estimated 20% of individuals. An estimated 85% of chronic LBP is of ambiguous etiology, and therefore unamenable to correction of an underlying condition. Pharmacological and surgical management of chronic LBP may have unwanted side effects and there are benefits to investigating alternative therapies such as acupuncture for relief of chronic pain.
Technology Description: The technique of acupuncture involves percutaneous insertion of very fine needles to a depth of approximately 10 to 15 millimeters at prescribed acupoints. In some cases, low-voltage current is applied to the needles; this is referred to as electroacupuncture.
Controversy: Concerns regarding the opioid epidemic have fueled considerable interest in nonpharmacological strategies, including acupuncture, for pain management in recent years. Numerous federal regulatory agencies have advised or mandated that nonpharmacologic options for pain be offered by healthcare systems and providers. Acupuncture is controversial in the United States because of lack of clear mechanisms for efficacy, inconsistent findings in studies in the peer-reviewed literature, and heterogeneity in techniques and treatment administration.
Key Questions:
- Does acupuncture reduce pain and improve function associated with chronic LBP?
- Is acupuncture safe for treating chronic LBP?
- What is the comparative efficacy and safety of acupuncture for chronic LBP compared with sham acupuncture, no treatment, usual care, or medication?
- Have definitive patient selection criteria been established for acupuncture for the treatment of chronic LBP?
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