Patients fifty consecutive patients 33 women, 17 men. But this ageold practice is now viewed as an acceptable supplementary treatment for certain low back pain, neck pain, and osteoarthritis conditions. Research is needed into the optimum timing for an acupuncture treatment package in a patient episode of low back pain, and to assess the value of repeated courses of acupuncture for. Effective for services performed on or after january 21, 2020 cms will cover acupuncture for medicare patients with chronic low back pain. However, there is a lack of basic dataset on the use of acupuncture to treat clbp in china and abroad, including the effective population characteristics.
Objective to determine if acupuncture is an effective, safe adjunctive treatment to standard therapy for chronic low back pain lbp in older patients. Current clinical guidelines for lowback pain recommend acupuncture for clbp. Acupuncture for chronic low back pain in longterm follow. Standardized versus individualized acupuncture for chronic.
Noninvasive treatments for acute, subacute, and chronic low back pain. Pdf acupuncture for chronic low back pain in older. Up to 12 visits in 90 days are covered for medicare beneficiaries under the following circumstances. Acupuncture for chronic low back pain cag00452n decision. Low back pain was the top 1 frequently treated indication in uss acupuncture clinic according to a crosssectional study 10. Acupuncture treatment of chronic low back pain was studied in a placebocontrolled doubleblind crossover trial completed by 77 patients. Decision memo for acupuncture for chronic low back pain cag. In all five measures of efficacy chosen for study the acupuncture group. The centers for medicare and medicaid cms will cover acupuncture for chronic low back pain. Pdf acupuncture for chronic low back pain in older patients. Liu l, skinner ma, mcdonough s, mabire l, baxter gd.
Application of acupuncture to treat low back pain page 2. A singlecenter randomized controlled singleblind trial was performed in a general medical practice in germany run by a chineseborn medical doctor trained in western and chinese medicine. A large multicentre study 5 of needle acupuncture for chronic low back pain clbp, analysed the effect of baseline scores of chronicity, pain intensity and depression on treatment outcomes. Because of the lack of rigorous efficacy studies, national evidencebased guidelines for acute low back pain have not recommended the use of either acupuncture or massage. However, it is not known whether the effects of acupuncture are due to the needling itself or nonspecific effects arising from the manipulation. The data do not allow firm conclusions about the effectiveness of acupuncture for acute low back pain. Reference management software, endnote x7, will be used to manage and screen. Acupuncture may sound like an exoticmaybe even improbabletreatment for chronic pain. The treatment administered on that occasion was based on. Medicare will cover acupuncture for chronic back pain aarp. The pain is described as a dull ache in the lumbosacral area with episodic aching in the posterior aspect of both thighs. Two further treatments were given during the followup assessment period of 6 months or longer. Acupuncture is the selection and manipulation of specific acupuncture points by penetrating the skin with fine needles.
Effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy. Pragmatic randomized trial evaluating the clinical and. Apr 09, 2019 acupuncture is effective for chronic pain, including low back pain 11. Efficacy and safety of thread embedding acupuncture for. Acupuncture has been consistently found to improve both pain and function in chronic low back pain, when used either alone or as an adjunct to conventional care. Acupuncture for lower back and pelvic pain in late. Acupuncture has been reported to be effective in providing symptomatic relief of chronic low back pain. Threadembedding acupuncture, acupuncture, chronic low back pain background low back pain lbp is a major health problem, with an estimated lifetime prevalence of up to 7085% 1 and high treatment costs. Upon the most recent national coverage analysis for acupuncture specifically targeted for chronic low back pain clbp cms determined it will cover acupuncture for clbp under section 1862a1a of the act effective for claims with dates of service on and after january 21, 2020. One hundred and fifty outpatients with chronic low back pain were. Acupuncture for the treatment of common pain conditions. Maria dalamagka, anaesthesiology department, general hospital of edessa, edessa 58200, greece, tel. Under certain circumstances, medicare, and therefore ucare, covers acupuncture for chronic low back pain.
The etiology of chronic low back pain is not clear, which means it is often refractory to treatment. Chronic lowback pain clbp is one of the most common pain conditions. Pdf efficacy of acupuncture for chronic low back pain. Acupuncture is being studied for its efficacy in alleviating many kinds of pain. A 45yearold construction worker with a 7year history of intermittent low back pain is seen by his family physician. A singleblind, randomised, placebocontrolled trial of superficial acupuncture in the treatment of low back pain was carried out by comparing 8 patients treated by acupuncture with 9 patients treated by placebo. Apr 27, 2020 the back pain consortium established through heal will conduct studies to better understand the mechanisms of common pain conditions such as chronic low back pain, develop improved diagnostic and treatment tools, and identify, prioritize, and test therapies that reduce the need for opioid use for millions of americans. Setting a tertiarylevel pain clinic at a swedish university hospital.
We aimed to compare the effectiveness of standardized and individualized acupuncture treatment in patients with chronic low back pain. Acupuncture and therapeutic exercise in the management of chronic lowback pain with lumbar spinal stenosis. As a medicare advantage plan, ucare covers all items and services that medicare covers. Function improved over short andor intermediate term for exercise, lowlevel laser therapy, spinal. This case report details the unexpected and sustained relief from chronic low back pain in a patient after a single acupuncture treatment. Benefits of offering acupuncture care to patients with. Acupuncture for low back pain canadian family physician. The chronic pain medical treatment guidelines consist of two parts. Up to 12 visits in 90 days are covered for medicare beneficiaries. Acupuncture for chronic low back pain in longterm followup. Acupuncture is an effective treatment for chronic low back pain, but this effect is likely to be produced by the nonspeci. Most patients with nonspecific acute lbp exhibit an unremarkable natural course. Acupuncture and dryneedling for low back pain cochrane.
However, 25% or more of patients have recurrent pain within the next year,4 and. Low back pain fact sheet national institute of neurological. Chronic low back pain acupuncture now foundation inc. In the vast majority of instances the cause of low back pain is obscure or nebulous, and these cases are the focus of concern for who 1, whose. Acupuncture is a widely used treatment, especially for chronic low back pain, and back pain is the most common reason for visits to acupuncturists. Back pain especially lower back pain is a common chronic pain issue.
Guidelines from the american pain society and american college of physicians say doctors should consider acupuncture as an alternative therapy for patients with chronic low back pain thats not. Acupoint injection for nonspecific chronic low back pain. Both sherman and fellow senior scientific investigator daniel cherkin note that from their study of 638 adults with chronic lowback pain, one of the biggest done in the u. For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the shortterm only. The good news is chronic low back pain is one of the conditions that research suggests acupuncture may be an effective tool for treating. Acupuncture in chronic pain, low back pain and migraine dalamagka m department of anaesthesiology, general hospital of edessa, edessa, greece corresponding author. Four english online databases and 4 chinese online databases will be researched systematically from their inception to december 31, 2018. This provides a framework to manage all chronic pain conditions, even when the injury is not addressed in the clinical topics section of the mtus.
A clinical casestudy article pdf available december 2016 with 57 reads how we. Introduction low back pain, which carries a 7085% lifetime risk in the general population andersson. Acupuncture involves the insertion of fine metallic needles into the body at. Effectiveness of acupuncture for low back pain wildwood. It is intended to assist healthcare providers in all aspects of patient care, including, but not limited to, diagnosis, treatment, and management. German acupuncture trials gerac for chronic low back pain.
Randomized trial comparing traditional chinese medical. However, 25% or more of patients have recurrent pain within the next year,4 and chronic low back pain develops in up to 7% of patients. A 45yearold man with a 7year history of low back pain asks his physician for a referral to a licensed acupuncturist. Acupuncture for chronic low back pain in routine care. Acupuncture for chronic low back pain semantic scholar.
Vadod clinical practice guideline for diagnosis and. Both sherman and fellow senior scientific investigator daniel cherkin note that from their study of 638 adults with chronic low back pain, one of the biggest done in the u. Research is needed into the optimum timing for an acupuncture treatment package in a patient episode of low back pain, and to assess the value of repeated courses of acupuncture for patients experiencing recurrent episodes of low back pain. However, there are very few highquality acupuncture studies on clbp in older adults. Sep 01, 2009 based on published evidence, acupuncture is most likely to benefit patients with low back pain, neck pain, chronic idiopathic or tension headache, migraine, and knee osteoarthritis. However, any corresponding policy changes that appear in the final decision memorandum will also be manualized in changes to ncd 30. Full text study of acupuncture for low back pain in recent 20 years. Acupuncture can reduce perceived pain, mood disturbances and medical expenses related to low back pain among factory employees. The aim of this study was to evaluate the effect of acupuncture injection therapy for the patients with nonspecific chronic low back pain clbp systematically. Superficial acupuncture in the relief of chronic low back. In patientlevel metaanalyses of randomized controlled trials that included. Pdf acupuncture treatment of chronic low back pain by.
Psychological therapies were associated with small improvements compared with usual care or an attention control for both function and pain at shortterm, intermediateterm, and longterm followup soe. Low back pain improved after acupuncture treatment for at least 6 months. Note that cms still determines that acupuncture for treatment of fibromya lgia or osteoarthritis is still not considered reasonable and necessary and remain noncovered by medicare. There are promising findings in some conditions, such as. There are promising findings in some conditions, such as chronic low back pain and osteoarthritis of. Noninvasive nonpharmacological treatment for chronic pain. Acupuncture has been found to be a costeffective treatment option8 and electroacupuncture has been found to be more cost effective than nonsteroidal antiinflammatory medications. Inclusion, exclusion andwithdrawalcriteria inclusion criteria 1. Superficial acupuncture in the relief of chronic low back pain. The patients had significantly increased depression.
Pdf chronic back pain is a major public health problem and the primary reason patients seek acupuncture treatment. Acupuncture for low back pain the college of family. Acupuncture is an ancient chinese physical therapy that has become a popular and wellresearched method for managing this pain. Discussions on realworld acupuncture treatments for. Effectiveness of acupuncture for nonspecific chronic low back pain. In that article, breivik reported that twothirds of respondents who suffered from chronic pain including lbp used alternative treatments, such as.
Low back pain is a common, impairing, and disabling condition, often longterm, with an. Acupuncture for chronic low back pain article pdf available in new england journal of medicine 36318. Using the treatment for low back pain in particular. For the purpose of this decision, chronic low back pain clbp is defined as. Chronic lbp it was defined as a complaint of pain of the lower back below the 12th thoracic vertebrae with or without radiation with an onset of duration of 6 months or more 2. Low back pain is an extremely common concern, affecting anywhere from 75 to 90 percent of people at some point in their lives. May 11, 2009 acupuncture like treatments had a positive effect overall on peoples chronic back pain, says study researcher dan cherkin, phd, a senior investigator at group health center for health studies. Evidencebasedapproachtothemanagementof chronic back pain. Decision memo for acupuncture for chronic low back pain.
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