The largest study to date of acupuncture for chronic low back pain has found the treatment eases the pain, improves back function and is cost effective.

“Acupuncture should be considered a viable option in the management of patients with chronic low back pain,” Dr. Claudia M. Witt of Charite University Medical Center in Berlin and colleagues conclude in a report in the American Journal of Epidemiology.

People are increasingly using complementary and alternative medicine to treat persistent low back pain, especially acupuncture, Witt and her team point out, but studies of acupuncture’s effects on low back pain have yielded mixed results.

To compare the effectiveness and costs of acupuncture along with routine care for low back pain to routine care alone, the researchers recruited 11,630 patients with chronic low back pain. Of these, 1,549 were randomly assigned to acupuncture and 1,544 to a control group. Patients in the control group were offered acupuncture after three months.

The remaining 8,537 patients were included in a nonrandomized acupuncture group.

Patients received up to 15 treatments over a three-month period, and were followed for an additional three months.

At three months, patients treated with acupuncture showed significantly better back function, on average; 52.6 percent responded to treatment, compared to 26.8 percent of control patients.

Nonrandomized acupuncture patients had more severe symptoms at baseline and showed improvements in back function similar to those seen in randomized patients.

Benefits were nearly equal for control patients who received acupuncture later in the study.

At six months, effects were slightly lower than they were at three months for patients who received acupuncture, with half of patients randomized to acupuncture showing a response.

Acupuncture was more costly than routine care for low back pain, but was deemed “cost-effective” in terms of the degree of improvement seen in patients’ back function.

SOURCE: American Journal of Epidemiology, September 1, 2006.