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I am going to see the local Chinese acupuncturist for a series of acupuncture treatments for my low back pain. How many sessions should I expect before I see improvement? And how many total visits should I schedule?

More and more studies are showing the positive effects of acupuncture on chronic low back pain. But differences in how the studies are conducted have made it difficult to narrow down the protocol to a specific number of treatments that is best for everyone. Individual patient differences (e.g., personality, stress and response to stress, socioeconomic) factors, psychological factors, and even workplace-associated contributing factors can affect results. New information from a recent study from the Department of Korean Rehabilitation Medicine may provide some useful information. They designed a study to compare the results of true acupuncture with sham acupuncture treatment. The two different types of treatment were used in the care of patients ages 18 to 65 who had nonspecific chronic low back pain (cLBP or LBP). Each patient reported pain levels as being a six or higher on a scale from zero (no pain) to 10 (severe pain). Patients were assigned to the sham treatment and the real acupuncture treatment in a random fashion. In this study, 130 patients received nonpenetrating sham acupuncture or true (penetrating) acupuncture twice a week for more than six weeks. Nonpenetrating acupuncture means a blunt tipped needle was used to make contact with the skin but without piercing through the skin. This way of providing a sham acupuncture treatment has been shown in past studies to be perceived as genuine by other patients. Points of stimulation used were NOT true acupuncture points to further differentiate the sham treatment from the real or true acupuncture treatment (which was applied to actual acupuncture points). Results were measured based on patient report of how "bothersome" the chronic low back pain (cLBP) was, pain intensity, general health status, and level of disability and depression. Patients in both groups reported significant improvement in the first two weeks. But the real acupuncture group had a much greater reduction of "bothersome" pain. Intensity of pain was also reduced more in the group receiving real acupuncture. Patients in the sham group who benefitted from this "treatment" may have been experiencing both physiologic and psychologic benefit from the expectation that acupuncture would help. The group receiving real acupuncture would have the same positive expectation but with the added benefit of a true physiologic (not just perceived) effect. Acupuncture is considered a safe and effective treatment for chronic low back pain (cLBP). Real acupuncture reduces the intensity and bothersomeness of cLBP more than sham acupuncture. The exact number of sessions needed has not been determined and is likely patient specific. As a general rule based on patient and acupuncturist experiences, expect a minimum of six sessions. See how you are doing and then reassess the need for further treatment.

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