Letters to the Editor

Acupuncture for Treatment of Chronic Low Back Pain


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Am Fam Physician. 2015 Oct 1;92(7):554.

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Original Article: Common Questions About Chronic Low Back Pain

Issue Date: May 15, 2015

Available at: http://www.aafp.org/afp/2015/0515/p708.html

Original Article: Common Questions About Chronic Low Back Pain

Issue Date: May 15, 2015

Available at: http://www.aafp.org/afp/2015/0515/p708.html

to the editor: I appreciated the article by Dr. Herndon and colleagues about chronic low back pain. I was surprised, however, that acupuncture was not mentioned as a treatment for this condition. Two meta-analyses found that acupuncture provided clinically significant pain relief compared with placebo and sham acupuncture when added to conventional therapies.1,2 Compared with the other treatment options discussed in the article, the adverse effect profile of acupuncture makes it a reasonable alternative, especially in individuals with a risk of addiction, those with chronic comorbidities, and those taking multiple pharmacologic agents.

Author disclosure: No relevant financial affiliations.


1. Furlan AD, van Tulder MW, Cherkin DC, et al. Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev. 2005;(1):CD001351.

2. Vickers AJ, Cronin AM, Maschino AC, et al.; Acupuncture Trialists' Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444–1453.

in reply: We thank Dr. Frank for his accurate assessment that acupuncture may be a useful and important adjunct in the overall treatment of chronic low back pain.1 We did not discuss acupuncture or dry needling because of concerns that adequate assessment and communication of the data were not feasible within our space constraints. In our experience, the variance in types of acupuncture performed, study control and blinding methods, and pain syndrome heterogeneity prevent a succinct assessment and clinical recommendation. Unfortunately, we also find that acupuncture is typically beyond the financial means of many of our patients and often not covered by third-party payers. Hopefully, as data continue to emerge examining specific forms of acupuncture and treatment durability, physicians will be able to more readily incorporate this modality into their treatment of chronic low back pain.

Author disclosure: No relevant financial affiliations.


1. Bahrami-Taghanaki H, Liu Y, Azizi H, et al. A randomized, controlled trial of acupuncture for chronic low-back pain. Altern Ther Health Med. 2014;20(3):13–19.

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This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.


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