Acupuncture for back pain & SCIATICA Bristol

Is there any evidence that acupuncture can help for back pain?

The Australian Acupuncture and Chinese Medicine Association commissioned a thorough review of evidence for the effectiveness of acupuncture for a wide variety of conditions. The result was The Acupuncture Evidence Project, published in 2017. 

They found strong evidence supporting the effectiveness of acupuncture in 8 conditions, including chronic low back pain. The other conditons were allergic rhinitis, chemotherapy-induced nausea and vomiting, headache, knee osteoarthritis, migraine prophylaxis, postoperative nausea and vomiting, and postoperative pain. Moderate evidence was found for a long list of other conditions, and importantly, the level of evidence was found to have increased between 2005-2016 for 24 conditions (including back pain). 

This review also found evidence that acupuncture is safe and well tolerated for back pain. 

Transcript from 'Acupuncture, tuina & cupping for back pain' video

'Hi, I'm Tom Kennedy, I'm an acupuncturist based in Bristol in the United Kingdom.  I made this video to demonstrate a 'typical' back pain treatment, but of course, acupuncture and tuina are always tailored to the individual and no two treatments are ever the same, so it's typical only in the broadest sense.  This patient has had nonspecific low-back pain over several years, as well as other inflammatory problems.  Taking his pulse and using other methods of assessment, my main conclusions from the Chinese medicine perspective were that this was a mixed pattern of excess and deficiency, with Kidney weakness, internal Heat, and localised Qi and Blood stagnation.  Whilst it's not shown here, I'd look at range of movement before treating, and a full discussion of diet and lifestyle factors is almost always an important part of recovery - what you see here is very much a condensed version of a single treatment, but hopefully it gives some insight into the process.

I tend to start with seated tuina massage for most musculo-skeletal problems.  One of the great things about tuina is that it allows me to start to get things flowing, by loosening the muscles and channels involved, as well as getting a sense of any areas that are tense and knotted, or weak and deficient.  The whole process is always both a treatment and a diagnosis.  

The area I'm working on here at the base of the skull, is around the acupuncture point fengchi, which translates as wind pool.  It's a crucial area for various reasons, not least because desk workers tend to accumulate tension there due to poor sitting posture.  Regular stretching and movement during the day can help, but we're just not designed to sit for long periods of time so it often needs attention.  

These passive spinal rotations again help loosen things up, as well as allowing me to gauge flexibility.  

I'm now using tuina in the prone position, and I'm continuing to open and clear the channels, mainly the Taiyang bladder channel, to increase circulation and prepare the ground for the rest of the treatment.  Taiyang is the longest, the most exterior, and the most yang in nature of the channels (link), and in traditional theory it's the body's first line of defense against external invasion from the environment.  During this phase of the treatment, I'm trying to encourage movement in this major channel, clearing downwards with long sweeping motions.  

I'll often use slide cupping when there's stagnation in Taiyang, which is a fantastic way to further increase circulation and draw out pathogens.  The flame creates a vacuum, which sucks the skin and underlying tissue up into the cup, and when it's moved over the region in this way, it's almost like an inverse massage.  Using the ancient Chinese analogy of the body as a landscape, and the channels as rivers flowing through that landscape, one of the main aims of any treatment is to irrigate the land in order to make it healthy and vibrant, and slide cupping does just that by teasing apart stagnant tissue and allowing blood to flow freely again.

The points I'm using here are Kunlun and Feiyang, both important points on the Bladder channel for lumbar area pain.  If I were just using acupuncture, I'd probably include Yin channel points too, to balance the treatment and help address the underlying deficiency.  But things are a bit more flexible when using bodywork as well, and in this case I worked on the deficiency more in the final stage of the treatment.

Here I'm needling two of the Huatuojiaji points, which lie in the depressions between all the spinous processes.  I'm focusing on the main area of pain now, having thoroughly opened up the channels with tuina and cupping.  

Now I'm using relatively thick 0.5mm needles with a threading technique, to really move local stagnation.  

Now that the needles are in, I'm using a rocking technique to gently stimulate all the points to keep them active. The rocking motion is also very relaxing, which helps increase the effect of the treatment. It also helps pave the way to the final phase of the treatment, where I use hand warmth and very gentle movements to settle and centre the patient.  

A typical treatment like this will take around 30-40 minutes, and the length of each phase will vary depending on the situation.  For example, if I feel stress and anxiety are a big part of the problem, I'll probably spend longer in the settling/centering phase, and sometimes even the whole session.  In other cases, I might use stronger pressure with the tuina, more needles and more stimulating needle techniques - it's always a balancing act, which is what makes it so fascinating to perform, and often so effective for the patient.  So if you suffer from back problems, why not find a qualified local practitioner, and give acupuncture and tuina a try.'

Tom Kennedy uses diet and lifestyle advice, tuina (Chinese massage) and acupuncture in his clinics in Bristol to help people suffering from stress and anxiety, as well as a number of other conditions. See the clinics page to make a booking.