Acupresssure -- pushing with the fingertips
at the same body points used in acupuncture -- gave patients
better, long-lasting relief for low back pain than conventional
physical therapy, Taiwanese researchers report.
"Acupressure was effective in reducing low back
pain in terms of disability, pain scores and functional
status," doctors at the National Taiwan University
reported in the current issue of the British Medical
Journal. "The benefit was sustained for six months."
The researchers recruited 129 people with chronic low
back pain from a specialist orthopedic clinic. All of
them filled out a standard disability questionnaire before
being assigned to one of two different treatment regimens,
with 64 people receiving six sessions of acupressure and
65 receiving standard physical therapy.
"Acupressure conferred an 89 percent reduction in
physical disability compared with physical therapy,"
the researchers reported. The people who got acupressure
also scored better on measures of pain and had fewer days
taken off from work or school, the researchers said.
However, they cautioned that the effectiveness of any
manipulative therapy such as acupressure "is highly
dependent on the therapist's technique and experience."
All the people in this study received treatment from the
same therapist, to eliminate any difference in the treatment
given.
"We hope that this technique can be imparted to
other therapists now that its efficacy has been shown
in our study, so that acupressure can be used in other
populations," they wrote. "How acupressure can
be generalized to patients with low back pain is the subject
of ongoing research."
Dr. Marcos Hsu is an acupuncture specialist at the University
of Maryland Center for Integrative Medicine who got his
training in acupuncture and acupressure at the Maryland
Institute of Traditional Chinese Medicine. He called the
Taiwan report "quite amazing," because the benefits
persisted for so long. But he added that he would like
more information on the causes of back pain in the people
treated in the study.
Hsu said he routinely uses acupressure supplemented with
acupuncture to treat low back pain. "I have seen
good responses similar to those in the paper, but some
people do not respond to it," he said. The response
generally is good for musculoskeletal problems such as
sprains, Hsu said, but when the pain is caused by problems
with structural bones and tissues, as in arthritis, the
treatment "may take longer to take effect."
Hsu's patients usually receive painkillers, as well,
because "most people who come to us are on painkillers,
so it is not advisable to stop," he said. Patients
can have anywhere from five to 15 treatments, with pressure
applied "by our thumbs, hands, wrists, knuckles,
elbows, every joint we can use," Hsu said.
People seeking acupressure or acupuncture treatment for
low back pain should be cautious whenever they seek out
help, Hsu recommended. "Check their credentials first,"
he advised.
The Taiwan study does have some flaws, added Richard
E. Harris, a research investigator in the rheumatology
division of the University of Michigan Medical School,
who has also done work on acupressure.
Harris said he'd like a more detailed account of the
treatment given -- which acupressure points were pressed,
for example. And he noted that the participants weren't
blinded to the treatment they were given. Patients who
got acupressure knew they were getting it, which might
have influenced their response, Harris said.
Nonetheless, the report that acupressure seems to be
better than physical therapy for back pain is significant
and deserves follow-up, he said.
