Unitedhealthcare medicare advantage policy guideline. Mar 24, 2016 acupuncture is no longer recommended as a treatment for low back pain on the nhs, according to new draft guidelines released today by the national institute for health and care excellence nice. It also entails enormous social and economic costs. Nonspecific low back pain is a common musculoskeletal disorder that has become a major health and economic problem hoy, et al. Varying structures can contribute to these symptoms, including the joints, discs and connective tissues.
For chronic lowback 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. For example, the american society of anesthesiologists states it may be considered in the treatment for nonspecific. Chronic pain, whether from a pinched nerve, sciatica, arthritis or other conditions can be very frustrating for the sufferer. Initial pain levels correlated with stateanxiety, depression, pain duration. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Up to 12 visits in 90 days are covered for medicare beneficiaries under the following circumstance. Effective for services performed on or after january, 21, 2020, cms will cover acupuncture for medicare patients with chronic lower back pain clbp. It is often difficult to treat nerve pain with traditional medications as nerve pain does not respond well to prescription pain relievers, including narcotics. Acupuncture has been studied for a wide range of pain conditions, such as postoperative dental pain, carpal tunnel syndrome, fibromyalgia, headache, lowback pain, menstrual. Acupuncture may sound like an exoticmaybe even improbabletreatment for chronic pain.
There are many therapeutic strategies, but longterm effects of single therapeutic approaches remain limited van tulder et al. Standardized versus individualized acupuncture for chronic. A 45yearold man with a 7year history of low back pain asks his physician for a referral to a licensed acupuncturist. In addition to the divergence of results, there is no yamamot among authors regarding the choice of acupuncture points and treatment methods systemic acupuncture, auricular acupuncture, electroacupunture, among others. The start back screening tool sbst although promising, has not been studied in patients with chronic low back pain clbp. Chronic low back pain is a major health problem in western countries, and is associated with high medical expenses, lost productivity, and disability. This thesis investigated the effectiveness of acupuncture in the management of low back pain, with a focus on one aspect of. One hundred and fifty outpatients with chronic low back pain. Using the incremental costeffectiveness ratio icer, i. Back pain is one of the top reasons people seek medical treatment.
But this ageold practice is now viewed as an acceptable supplementary treatment for certain low back pain, neck pain, and osteoarthritis conditions. To investigate the effects of an isolate myofascial release mfr protocol on pain, disability, and fearavoidance beliefs in patients with chronic low back pain clbp. There is a range of acupuncture variants which originated in different. Acupuncture is one of the most frequently sought complementary and alternative medicine modalities for treating low back pain. Efficacy of acupuncture and electroacupuncture in patients.
It can cause many physical, mental, and emotional problems on the victim mendelson, selwood, kranz, loh. The data do not allow firm conclusions about the effectiveness of acupuncture for acute lowback pain. Chronic back pain is a major public health problem and the primary reason patients seek acupuncture treatment. Nearly 8 out of every 10 people will have low back pain at some point in life. Up to 12 visits in 90 days are covered for medicare beneficiaries. Acupuncture for chronic low back pain cag00452n decision.
Acupuncture is a pseudoscience because the theories and practices of tcm are not based on scientific knowledge, and it has been characterized as quackery. Acupuncture treatment of chronic low back pain was studied in a placebocontrolled doubleblind crossover trial completed by 77 patients. Internal validity and external validity of systematic. This study addresses methodological shortcomings that have plagued previous. Back pain was the most common, followed by joint pain, neck pain, severe headachemigraine, and recurring pain. Acupuncture is no longer recommended as a treatment for low back pain on the nhs, according to new draft guidelines released today by the national institute for health and care excellence nice. Acupuncture for chronic low back pain clinical therapeutics, n engl j med 2010. Cleveland acupuncture for sciatica, arthritis, low back pain. It is the uks leading cause of disability and one of the main reasons for workrelated sickness absence. Acupuncture for chronic low back pain in routine care article in clinical journal of pain 232. Acupuncture for chronic low back pain in longterm follow. Trigger point, low back pain, elderly, randomised controlled trial. A 45yearold construction worker with a 7year history of intermittent low back pain is seen by his family physician. Effectiveness of acupuncture for nonspecific chronic low back pain.
Complementary and alternative medicine cam therapies are widely used 510, and acupuncture was shown to be useful for chronic low back pain 1114. Effects of myofascial release in nonspecific chronic low back. Superficial acupuncture in the relief of chronic low back. Pdf efficacy of acupuncture for chronic low back pain. Chronic lowback pain lbp is an important health issue in western countries and is associated with high medical expenses, disability, and inability to work van tulder et al. As a medicare advantage plan, ucare covers all items and services that medicare covers. Pdf this case report details the unexpected and sustained relief from chronic low back pain in a patient after a single acupuncture treatment. However, the question remains whether individualized acupuncture, which needs more.
The effectiveness of acupuncture in treating chronic non. The acupuncture randomized trial in low back pain was part of a larger acupuncture project initiated by the german federal committee of physicians and health insurers. Low back pain is second only to the common cold as a cause of lost days at work and is one of the most common reasons to seek medical care, including acupuncture. The acupuncture treatment costs are reimbursed by the german statutory health insurance companies. Acupuncture in patients with chronic low back pain. Stratification strategies based on identifying patients prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research. For the purpose of this decision, clbp is defined as. The optimal management of nonspecific low back pain appears to be undecided. In all five measures of efficacy chosen for study the acupuncture group. Routine reimbursement for acupuncture in germany for chronic low back pain and osteoarthritis of the kneea. Patients with subacute low back pain 12 weeks or less andor chronic low back pain more than 12 weeks were included. Most have been of low methodologic quality, and, accordingly, metaanalyses based on these rcts are of questionable interpretability and value. 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 case series allyson augusta shrikhande, md,1 robert a.
Effectiveness of acupuncture for low back pain wildwood. Back pain can affect anyone at any age and most people will suffer from it at some point in their lives. There is 58% life time prevalence of back pain in the uk, a 2265% 1year prevalence and 67% of all adults have constant back problems 2. Low back pain is a common musculoskeletal disorder defined as pain and soreness, muscle tension, or stiffness in the lumbosacral area of the spine which does not have a specific cause. We aimed to compare the effectiveness of standardized and individualized acupuncture treatment in patients with chronic low back pain. Chronic low back pain is a costly medical complaint in canada and other industrialized nations. Acupuncture for chronic low back pain in older patients. Acupuncture for treatment of chronic lowback pain caused.
Considering how challenging it is to translate research into practice, the value of. The effectiveness of acupuncture in nonspecific chronic low back pain. The patients had significantly increased depression, neuroticism, and hypochondriasis scores. Costeffectiveness of acupuncture treatment in patients with chronic neck pain. The optimal management of nonspecific low back pain appears. Exercise and auricular acupuncture for chronic lowback pain. 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. Low back pain is an extremely common concern, affecting anywhere from 75 to 90 percent of people at some point in their lives.
The committee recommended that studies be conducted on the efficacy of acupuncture in the treatment of pain for 3 diseases, including chronic low back pain. Acupuncture for low back pain no longer recommended for. 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. Pdf acupuncture treatment of chronic low back pain by using. Acupuncture is a family of procedures that originated in traditional chinese medicine. Acupuncture a is a form of alternative medicine and a key component of traditional chinese medicine tcm in which thin needles are inserted into the body. Chronic pain caused by lumbar stenosis remains a challenging clinical issue. Low back pain is second only to the common cold as a cause of lost days at work and is one of the most common reasons. Acupuncture for treatment of chronic lowback pain caused by lumbar spinal stenosis.
National coverage determination ncd for acupuncture for. In most cases,the specific etiology of the problem cannot be clearly identified, and treatment. Acupuncture for low back pain no longer recommended for nhs. Feb 01, 2011 using the incremental costeffectiveness ratio icer, i. The data do not allow firm conclusions about the effectiveness of acupuncture for acute low back pain. Acupuncture is the selection and manipulation of specific acupuncture points by penetrating the skin with fine needles. This study addresses methodological shortcomings that have plagued previous studies evaluating acupuncture for. Top synonym for low back pain another word for low back pain is lumbago. The result highlights central questions about how acupuncture helps people with chronic pain. Setting a tertiarylevel pain clinic at a swedish university hospital.
Trigger point acupuncture treatment of chronic low back pain in received treatment at traditional acupuncture points for low back pain, while the other. Mfr is a form of manual medicine widely used by physiotherapists in the management of different musculoskeletal pathologies. Working adults ages 18 to 64 represent 63% of the population and account for 72% of all low back pain lbp health care visits. Acupuncture is widely used by patients with low back pain, although its effectiveness is unclear. Original investigation acupuncture in patients with. The middle initial of the second author page 454 was incorrect as. It can cause many physical, mental, and emotional problems on the victim mendelson, selwood, kranz, loh, kidson, scott, 1983. Rcts that included subjects with low back pain caused by specific pathological entities such as infection, metastatic diseases, neoplasm, osteoporosis, rheumatoid arthritis or fractures were excluded. 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. 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 achieved better outcomes when compared with other treatments.
This thesis investigated the effectiveness of acupuncture in the management of low back pain, with a focus on one aspect of dosage, i. Effects of myofascial release in nonspecific chronic low. Acupuncture, a complementary therapy for the treatment of chronic pain, works by stimulating the nervous system and allowing for the body to regain balance in december 2007, the center for complementary medicine research out of munchen, germany filed a report on the efficacy of. Therefore, an objective assessment of acupuncture efficacy is critical for making informed decisions about its appropriate role for patients with this common condition. Chronic low back pain lbp is an important health issue in western countries and is associated with high medical expenses, disability, and inability to work van tulder et al. Patients report more pain relief from acupuncture than conventional treatment. Pdf chronic back pain is a major public health problem and the primary reason patients seek acupuncture treatment. Acupuncture is generally only used in combination with other forms of treatment. The centers for medicare and medicaid cms will cover acupuncture for chronic low back pain. Acupuncture is increasingly being recognized by western medicine as an effective alternative or adjunct to conventional treatments for a long list of conditions including headache, menstrual cramps, joint pain, low back pain, and asthma, as well as for the side effects of chemotherapy and nausea related to pregnancy. Backache alternative treatment acupuncture clinical trials. Although acupuncture, a part of traditional chinese medicine tcm, is one of the oldest healing arts in. Electroacupunture, acupuncture, low back pain, physiotherapy background low back pain is a serious public health and socioeconomic problem worldwide.
Superficial acupuncture in the relief of chronic low back pain. Acupuncture is an effective treatment for chronic low back pain, but this effect is likely to be produced by the nonspecific effects of manipulation. Disc degeneration and facet joint degeneration have been correlated. Decision memo for acupuncture for chronic low back pain. Although most low back pain is nonspecific and selflimiting, a subset of patients develop. Application of acupuncture to treat low back pain page 2. Acupuncture is not more effective than other conventional and alternative. Acupuncturelike treatments improve low back pain national. A treatment for lower back pain chronic lower back pain is a major health disorder in the world today mendelson, selwood, kranz, loh, kidson, scott, 1983. Acupuncture and dryneedling for low back pain cochrane. To determine if acupuncture is an effective, safe adjunctive treatment to standard therapy for chronic low back pain lbp in older patients. Acupuncture and simulated acupuncture both improved chronic low back pain more than conventional care in a new study. Aug 19, 2015 stratification strategies based on identifying patients prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research.
Acupuncture has been studied for a wide range of pain conditions, such as postoperative dental pain, carpal tunnel syndrome, fibromyalgia, headache, low back pain, menstrual. Chronic low back pain clinical outcomes present higher. Acupuncture treatment of chronic lowback pain a randomized. Considering how challenging it is to translate research into. Low back pain results in high health costs and incapacity to work causing an economic burden to society. Acupuncture involves the insertion of fine metallic needles into the body at. Acupuncture for chronic low back pain in routine care. Chronic low back pain clbp is a major health issue in the western world and is a significant burden on health care. Common questions about chronic low back pain american. Patients with chronic low back pain are more likely to see a family physician 65.
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