Acupuncture for Back Pain and Neck Aches

When you bring your backache to your healthcare provider, you likely expect, and hopefully get, an explanation as to why it’s hurting and what you should do to make it stop. Maybe you have pain, numbness, weakness, or electrical sensations that travel down one leg or arm. (This is called radiculopathy.) Or maybe you’re stiff, and you wonder why. (Hint: This could be a sign of spinal arthritis.)

Such expectations (which are, by the way, fairly common) are to a great extent, what our Western medical industry is built on—a structural approach to (in this case) spine pain and its solutions. This approach is also known as the “mechanical view” or the “mechanical approach.”

The mechanical approach is all about what’s wrong in one or more of the body’s tissues and what steps should be taken to fix it.

Our Western medical system occupies most of the thinking about and attention to health in the U.S. But in the last 30 years or so, the use of holistic therapies—especially for neck, back, and other joint problems—has been making its way towards the mainstream. One of the most popular of these treatments is acupuncture.

“Back and neck (and to some extent knee) pain is the bread and butter of an acupuncture business,” says Michael L. Fox, Ph.D., president of the California Acupuncture Association and owner of Silverlake Acupuncture in Los Angeles. Fox adds that for most acupuncturists, the percentage of joint pain patients hovers around the 80 percent mark.

“Acupuncturist students receive very good training in treating back and neck pain,” Fox explains. “So a lot of new acupuncturists launch their careers by specializing in these kinds of problems. But as time goes on, the practitioners may branch off into other specialties, for example, women’s or men’s health.”

What Is Acupuncture?

One of several therapies in the Traditional Chinese Medicine system, acupuncture involves the insertion of sterile needles into specific points that run along lines of energy called meridians. The idea is that energy, which the Chinese call “qi” (pronounced “chee”) flows in a healthy, harmonious body. But when we’re not feeling well, energy can get stuck or stagnant or become deficient. The purpose of inserting needles into the points is to get the qi flowing again.

There’s much more to it, as you will see below, but that’s the basis of acupuncture treatment, whether for a spine problem or for something else.

Acupuncturists, for the most part, are independent holistic providers who believe strongly in the Chinese philosophy of health. That said, more and more, conventional providers, especially D.O.s and M.Ds, are adding acupuncture to the services they provide, and this is called medical acupuncture. In general, though, a licensed acupuncturist will have gone through a three or four-year Master’s program and be licensed by their state, and in some cases a doctoral program. The length of the program depends on the chosen curriculum.

As you may have guessed, getting a diagnosis and treatment for your back or neck pain by an acupuncturist is not at all like going to an M.D. for the same.

“Acupuncturists think differently,” Dr. William Welches, D.O. at the Cleveland Clinic Department of Pain Management informs me. “Chinese medicine is distinct from Western medicine,” he continues. “We [Westerners] think in terms of this medicine or therapy for that problem. Chinese medicine takes the patient's personality into account. It’s a remarkably complex system.”

It’s about patterns.

Take sciatica, for example. Welches says that a good portion of a sciatica diagnosis depends on patterns of energy flow and blockage that affect the entire system—not just your back.

“The same diagnosis of sciatica may lead to the need for stimulation of different meridian lines and points in different patients,” he says.

Which point or points to target for increasing the flow of qi depends on a number of things. Here’s the shortlist:

• Type of acupuncture practiced. Fox says that Traditional Chinese Medicine is the system most acupuncturists learn in school, but a number of others exist, as well, and many practitioners obtain advanced training in one or more of these.
• Your specific Chinese diagnosis.
• Any allopathic diagnosis (i.e., diagnosis by a licensed M.D.) that is communicated to your Chinese doctor. Often a Chinese practitioner factors in the Western medical diagnosis as a way of narrowing down the potential diagnostic patterns under consideration, Fox says.
• Number of years your practitioner has been working in the field.
• The practitioner’s treatment style and/or preference.
• The number of years the practitioner has been working in the field.

Acupuncture and Chinese Medicine Back Pain Diagnosis Patterns

Fox says Chinese diagnosis of neck or back pain often comes down to two things: energy (qi) and blood. Each is a substance that normally moves through the body but can get stuck when we don’t feel well. By the way, blood in Chinese medicine is not like what we westerners usually understand as blood. The Chinese practitioner will evaluate the status of the flow of blood, not its constituents.

Fox clarifies by saying that many things can cause neck or back pain. While the cause often correlates with a particular diagnostic pattern, this is not a given, he says.

That said, here are four of the most common scenarios Fox says acupuncturists encounter and diagnose in their back pain patients:

• Trauma, for example from a car accident often is diagnosed as stagnation of blood (which may lead to a local stabbing pain in the low back.)
• People over the age of 40 often experience kidney qi deficiency, Fox says. He adds that the kidney meridian has a lot to do with the spine, low back, and knees. When the kidney qi is not strong, you may find your joints are weak and stiff. Also, he says, Western-type disorders of the kidney can traumatize this organ, which may further contribute to kidney qi deficiency.
• Another type of back pain is related to anger, emotion, and stress management, says Fox. This often manifests as things like road rage, frustration, and the like. The diagnostic pattern an acupuncturist may consider in this case is called liver chi stagnation.
• And finally, there’s an invasion of wind-cold. “Cold tends to slow down blood circulation, which can result in stagnant blood and possibly pain,” Fox says. If you live in a cold climate or you ice your back a lot, you may be at risk for invasion of wind-cold. Symptoms that tend to show up with this pattern include a tight and painful low back, low energy, and frequent urination.

Are There Side Effects With Acupuncture?

As with many holistic treatments, acupuncture side effects are uncommon. The National Center for Complementary and Integrative Health (NCCIH) confirms this, saying: "Relatively few complications from using acupuncture have been reported."

The NCCIH goes on to say that most of the time, the problems that do occur are related to contaminated needles. The FDA regulates the standards by which needles are manufactured and labeled; they require the needles to be sterile, nontoxic, and labeled for single use by licensed practitioners only. Acupuncture needles are often packaged singularly, as well, making contamination even less likely.

But what happens in those rare instances when a needle is contaminated? The NCCIH says this can cause an infection or other serious problems. And, if your practitioner is not properly educated or does not have a lot of experience at their craft, they may actually puncture an organ or lung or injure a nerve. But again, these kinds of complications are very rare.

Be Your Own Healer

Like most or all other holistic therapies, with acupuncture, it’s best to see yourself as an active participant in your own healing. But, you may wonder, if all you do during an acupuncture session is lie on a table for 20-30 minutes with needles in you, how can you participate actively?

This happens on your own time. As mentioned above, acupuncture is but one of a number of treatments, therapies, and lifestyle guidelines that are under the umbrella of Traditional Chinese Medicine (TCM). Other treatments you might get from a TCM practitioner include tuina massage or moxibustion. As you can guess, tuina is a Chinese massage system that, similar to acupuncture, seeks to restore harmony and flow to the qi. Moxibustion is a treatment that introduces heat to acupuncture points, also to help increase the flow of qi.

Chinese herbal therapy is another basically passive treatment that has helped many overcome health problems.

While you can certainly make and enjoy appointments for these related treatments, as an active participant in your own healing, you may also want to turn to daily practices in your own life that can complement and strengthen the benefits you receive from acupuncture.

To that end, your TCM practitioner may counsel you on diet and exercise. That information will likely be tailored to you individually. But when it comes to being active, TCM offers two well-known systems that empower you to actively harmonize your qi. They are Qigong and tai chi.

Qigong and tai chi

Tai chi is a system of slow movements performed in a standing position. Many people do tai chi as meditation, while others see it as a martial art. Still, others engage with tai chi strictly for health benefits.

Qigong uses breathing, postures, and your intention to create the same (or similar) effect as acupuncture, according to Crystal Muscatello, certified qigong instructor and founder of the Qi House in Berea, Ohio. “While acupuncture needles can stimulate energy or qi directly," she says, "qigong works less directly to achieve a similar end.”

A big difference between acupuncture and qigong, Muscatello adds, is that qigong is a low-intensity activity; in other words, you are in control the whole time and can modulate for yourself the effect of the experience. If standing proves too uncomfortable, for example, you can modify your qigong practice so that you are lying on your back or sitting down.

This is not to say you can’t control the intensity of your experience with acupuncture needles. But the best thing to do in that case is to communicate well and thoroughly with your provider.

What the Research Says

You may be wondering how effective acupuncture is. Has it passed the muster of medical research?

The National Center for Complementary and Integrative Health says for pain conditions, the answer is yes—you may be able to get pain relief for your particular neck or back condition using acupuncture. But, they caution, for other things, they are not so sure.