Acupuncture Treatment for Spinal Stenosis
Pain with Acupuncture
Unfortunately, many turn to acupuncture as a last resort for spinal stenosis treatment when all other options have been exhausted, making the assessment of the therapy’s benefits difficult in most circumstances. However, some research has been conducted in recent years showing that alterations in blood pressure and blood flow can occur with acupuncture treatment leading to clinically significant responses in those with lumbar spinal stenosis (Inoue, et al, 2005). Sciatic nerve blood flow appears to be affected by acupuncture, with an animal study (Inoue, et al, 2005) finding that pudendal nerve stimulation and sciatic nerve stimulation through electroacupuncture increased sciatic nerve blood flow by 100% in both cases, compared to a 56.9% increase in those models undergoing lumbar muscle stimulation. Inoue’s 2005 study observed alterations in vasodilator and vasoconstrictor nerve activity which affected the experience of intermittent claudication in those subjects with cauda equina syndrome.
Further evidence of acupuncture’s effect on back pain was found by Inoue (et al, 2008) when attempting to isolate target areas for treatment of lumbar spinal stenosis. Considerable reductions in lower limb pain was found in those patients undergoing pudendal nerve electroacupuncture, overall walking distance was improved, and low back pain also decreased in these patients. The authors of this study concluded that this particular nerve was considerably more effective at treating lower limb and lower back pain and radiculopathy in spinal stenosis than conventional acupuncture treatment.
Acupuncture Can Help Reduce Your Pain Medication
In many patients with spinal stenosis the condition is due to a progressive degeneration of the tissues and structures of the spine rather than any acute trauma. Many of these patients will have other illnesses or pathologies and a reliance on pain medication can increase their chances of an adverse drug reaction. The problem of polypharmacy in the elderly is an increasing one, with numerous interventions attempted to reduce the number of medications that many patients end up taking on a daily basis. Unfortunately, many of these strategies fail leaving patients vulnerable to, and reliant on, their many medications.
A case study by Tu (et al, 2009) looked at an 87yr old lady with polypharmacy and a history of osteoarthritis and spinal stenosis. After numerous hospitalizations and long lists of pain medication prescribed the lady underwent acupuncture treatment at an integrative clinic using Eastern and Western medicine in tandem. With acupuncture, trigger point therapy, and education on self-acupressure, the patient’s pain dissipated, she gradually reduced her pain medications until she became analgesic-free and had significantly improved quality of life. Simply accepting that back pain and joint pain is inevitable as we age is unhelpful and any doctor suggesting that attempts to lessen the pain and improve daily living standards are futile is not providing the best patient care that they can.
Acupuncture – An Increasingly Common Spinal Stenosis Treatment
In a 2010 study of patients suffering from lumbar spinal stenosis, and physical therapists treating them, the most frequently advocated treatments included physical therapy strategies such as flexibility (87%), stabilization (86%) and strengthening exercises (83%), followed by heat/ice (76%), acupuncture (63%) and joint mobilization (62%) (Tomkins, et al, 2010). Unfortunately, an assessment of the relative benefits of the treatments was beyond the scope of this study. A review of a number of studies looking into acupuncture for non-specific low back pain found that acupuncture was more effective at relieving pain than no treatment but that it did not vary in significance from sham acupuncture treatment (Yuan, et al, 2008); these results may reflect the fact that the condition was non-specific low back pain rather than an isolated or targetable pathology such as spinal stenosis at a single level. A study looking at 132 patients prior to lumbar disc protrusion surgery found that classic acupuncture relieved pain significantly in comparison to sham acupuncture and that the effect lasted longer with the targeted treatment (Wang, et al, 2000).
Does Acupuncture work for Treating Spinal Stenosis?
Studies into acupuncture for spinal stenosis are largely of poor methodological quality and offer little in terms of hard evidence to strongly support its use. However, there is a wealth of lower quality evidence showing acupuncture to be more effective than no treatment for reducing the pain symptoms of spinal stenosis. As the treatment has considerably fewer side-effects than many pharmaceutical pain medications and is less invasive than spinal stenosis surgery its use as a pain management therapy is indicated. Treatments appear to convey an immediate and short-term pain relieving action with results not usually observed over subsequent weeks and the necessity for further sessions to keep pain at bay (Furlan, et al, 2005). An acupressure mat may provide a suitable treatment in-between appointments.
What to do next
Patients are advised to find out if they can obtain acupuncture treatment through their doctor and to find a registered and certified acupuncturist if pursuing the therapy privately. The needles used in acupuncture are usually disposable, single-use needles, removing the need for hygiene concerns; if you have any doubts over a particular clinic or practitioner then you should report them to the relevant authority in order to keep the treatment safe for all. Acupuncture can help relieve pain by directly affecting pain signalling and by helping you to relax, lower your blood pressure, and reduce the symptoms of conditions such as depression, fibromyalgia, and chronic pain.
Inoue M, Hojo T, Yano T, Katsumi Y., (2005), Effects of lumbar acupuncture stimulation on blood flow to the sciatic nerve trunk–an exploratory study, Acupunct Med. 2005 Dec;23(4):166-70.
Inoue M, Hojo T, Nakajima M, Kitakoji H, Itoi M, Katsumi Y., (2008), Pudendal nerve electroacupuncture for lumbar spinal canal stenosis – a case series, Acupunct Med. 2008 Sep;26(3):140-4.
Inoue M, Kitakoji H, Yano T, Ishizaki N, Itoi M, Katsumi Y., (2008), Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms-The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow, Evid Based Complement Alternat Med. 2008 Jun;5(2):133-43.
Tu B, Johnston M, Hui KK., (2009), Elderly patient refractory to multiple pain medications successfully treated with integrative East-West medicine, Int J Gen Med. 2009 Nov 30;1:3-6.
Tomkins CC, Dimoff KH, Forman HS, Gordon ES, McPhail J, Wong JR, Battié MC., (2010), Physical therapy treatment options for lumbar spinal stenosis, J Back Musculoskelet Rehabil. 2010;23(1):31-7.
Yuan J, Purepong N, Kerr DP, Park J, Bradbury I, McDonough S., (2008), Effectiveness of acupuncture for low back pain: a systematic review, Spine (Phila Pa 1976). 2008 Nov 1;33(23):E887-900.
Furlan AD, van Tulder M, Cherkin D, Tsukayama H, Lao L, Koes B, Berman B., (2005), Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the cochrane collaboration, Spine (Phila Pa 1976). 2005 Apr 15;30(8):944-63.
Wang RR, Tronnier V., (2000), Effect of acupuncture on pain management in patients before and after lumbar disc protrusion surgery–a randomized control study, Am J Chin Med. 2000;28(1):25-33.