Acupuncture back pain success determined by psychological factors

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Acupuncture back pain success determined by psychological factors


According to new research, people being treated for lower back pain with acupuncture are more likely to gain less benefit from the treatment if they have low expectations of how effective it is.

Acupuncture can be used as a form of treatment for conditions including neck pain, sciatica and depression.

The study, published in The Journal of Clinical Pain, also suggests that patients who are positive about their back pain and feel in control of their symptoms go on to experience less back-related disability while receiving acupuncture.

“The analysis showed that psychological factors were consistently associated with back-related disability,” says study author Dr. Felicity Bishop. “People who started out with very low expectations of acupuncture – who thought it probably would not help them – were more likely to report less benefit as treatment went on.”

Well established as a form of complementary therapy, acupuncture is commonly used to treat a wide range of health problems. The World Health Organization (WHO) has stated that acupuncture is an effective form of treatment for 28 conditions, including lower back pain and the following:

  • Allergic rhinitis
  • Depression
  • Headache
  • Essential hypertension
  • Stroke.

Evidence also suggests that acupuncture could be beneficial in the treatment of many other diseases, symptoms and conditions, although the WHO believe further proof is needed.
However, previous research has also found that factors other than the insertion of needles into specific areas of the skin play a part in how effective acupuncture is. These factors include the patient’s belief in the therapy and the relationship between the patient and acupuncturist.

For the study, 485 people receiving acupuncture for lower back pain were recruited, being seen by a total of 83 acupuncturists. The participants completed questionnaires prior to the commencement of their treatment, and then again after 2 weeks, 3 months and 6 months.
The questionnaires measured demographic characteristics and lower back disability, as well as variables from four different psychological theories for predicting lower back pain outcomes: the fear-avoidance model, the common sense model, expectancy theory and social-cognitive theory.

‘Processing of different emotions in relation to treatment can influence outcomes’

As hypothesized by the authors, psychological variables were associated with changes in disability among the participants and were accountable for two thirds of the variance in disability.

“Factors such as the relationship between practitioner and the patient can inform this and we should be able to understand the biological pathways by which this happens,” concludes Dr. Simpson. “This understanding could lead in the future to better targeting of acupuncture and related therapies in order to maximize patient benefit.”

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