CAM Treatment for Low-Back Pain, Research Paper Example

Many people in the United States live with pain every day. There are various types of pain in different parts of the body that people experience; however, one that stands out the most is likely low-back pain. This is one of the most popular patient complaints, according to research. The purpose of this paper is exploring low-back pain and its causes, as well as CAM (complementary and alternative medicine) treatments and the various modalities for treating low-back pain within this method of treatment. These modalities include alternative healthcare therapies such as acupuncture, meditation, chiropractic, homeopathic, yoga, relaxation, aromatherapy, massage therapy, naturopathic, electromagnetic, and therapeutic touch. Of these, research shows the two most popular are acupuncture and massage therapy. Therefore, this paper explores these two topics in depth.

Low-back pain is a common condition that causes many people every day suffering in the United States and all over the world. Low-back pain comes in varying degrees and can range from mild aching to severe and debilitating agony and is caused by or can lead to other serious conditions. Research statistics show that 70-85% of American adults have problems with low-back pain at some point in their lives (Rooney, 2008). According to the National Institute of Neurological Disorders and Stroke, at least $50 billion a year is spent on low-back pain treatment and management in the U.S. and it is the most common cause of missed work days and job-related disabilities and sickness, and low-back pain problems can inhibit a person’s daily life activities (NINDS, 2013). Additionally, the Institute reports that “back pain is the second most common neurological ailment in the United States — only headache is more common” (para. 1).

Low-back pain diagnoses fall into one of two categories, which are 1) acute and 2) chronic. Acute low-back pain is usually short-term pain lasting up to a few weeks and is usually caused by some type of injury such as from playing sports, heavy lifting, or the results of being in a car accident. Chronic back pain usually last longer than just a few weeks. Back pain lasting over three months is considered chronic and this type of back pain often gets worse over time, leading to other serious issues that may need surgical intervention (NINDS, 2013). Based on research statistics, low-back pain affects millions of people every day from various causes that include aging, injury, trauma, and disease.

Causes of Low-back Pain

Millions of people, every day, complain about the pain they experience in their lower backs. There are several reasons why low-back pain occurs; however, the most common reasons are aging, arthritis, strain, disc disease, osteoporosis, or skeletal problems. When people age, so do their bones, muscles and ligaments and they can lose bone strength and muscle tone, which causes a loss in range of motion. Decreased range of motion causes over-extension of muscles, tendons and ligaments and can cause low-back pain or even injury. Decreased range of motion causes a decrease in the cushioning between the joints and around the vertebrae, which puts pressure on the back and causes pain (NINDS, 2013).

Arthritis and osteoporosis can also be conditions of aging that cause low-back pain. Arthritis in the back can cause spinal stenosis (narrowing of the spine), which causes the nerves in the spine to become compressed, causing low-back pain. Osteoporosis causes pain from compression fractures in the spine (Mayo Clinic Staff, 2012). Disc disease can result in a bulging or ruptured disc in the back. This is very painful because the discs serve as cushions between the vertebrae in the back and without these cushions, tremendous pressure is put on the nerves and causes excruciating pain. Additionally, when one strains the back, due to heavy lifting or over-extension from exercise or injury, low-back pain can occur. Bulging or ruptured discs can also occur in this way. Moreover, skeletal problems such as scoliosis results in pain due to the abnormality of the spine. Other causes of low-back pain include obesity, poor physical condition, bad posture and stress (NINDS, 2013).

With all the different causes of low-back pain and the varying severities of this condition, many people suffering with it look for ways to treat it without surgery. There are remedies (short of surgery) that often help with low-back pain, such as using cold or hot compresses, bed rest, and medications. However, there are times when these approaches do little to no good for some people with low-back pain and they often seek out alternative health therapies for relief.

Complementary and Alternative Medicine

Alternative healthcare therapies include treatments such as acupuncture, meditation, chiropractic, homeopathic, yoga, relaxation, aromatherapy, massage, naturopathic, electromagnetic, and therapeutic touch. These therapies are health interventions that often use natural remedies and mind-body alternative therapies using body manipulation and energy field interventions. These alternative therapies are included in the CAM (Complementary and Alternative Medicine) approach to healing (NCCAM).

Research in the area of mind-body therapies in alternative treatement shows promise in the area of pain management. Studies show that two of the most popular CAM treatments are massage therapy and acupuncture for pain management. In addition, CAM treatment is a growing trend. Approximately 40 percent of Americans seek out alternative treatments, such as acupunture and massage thereapy, for specific conditions or to take care of their overall well-being and many specialty treatment centers integrate alternative therapies with conventional therapies (NIH, 2013).

Acupuncture as a CAM Treatment

Acupunture is a health practice that has been a part of Asian cultures for thousands of years and involves fine needle insertion along specific points on the body. The purpose of this treatment is to trigger the release of peptides from the brain, which are natural painkillers. Acupunture also regulates the body’s vital energy flow along pathways in the body known as meridians or channels (NINDS, 2013). In other words, acupuncture promotes healing by redistributing energy in the body. According to the National Institutes of Health, acupuncture research shows the treatment is effective in relieving chronic pain. Additionally, it is reported that chronic low-back pain is the most common use for acupuncture in the U.S. and is considered a safe therapy, if performed correctly. This is key. This procedure must be performed in the correct manner or it could result in adverse affects. This is why it is best that patients seek out and only use licensed, experienced acupunturists.

Qualified acupunturists usually use traditional acupuncture treatments; however, there are some non-traditional acupuncture treatments that may use additional needling points not associated with meridians, in conjunction with needle stimulation. Needle stimulation uses electricity, herbs, or herb burning at the end of the needle (moxibustion). Dry-needling is another technique used for non-specific low-back pain, which involves needle insertion at trigger points (Rooney, 2008).

Acupunture vs. Placebo

Results of two large 2005 clinical trials show a significant difference between the effectiveness of placebo acupunture and acupuncture in research control groups. The studies focused on analysing the analgesic effects of both acupuncture and placebo acupuncture and what treatment type is most associated with positive effects on controlling low-back pain. Data for the studies was collected on cause of the pain, severity of pain, number of patients, duration of treatment and number of treatment sessions. Data analysis showed both small and large effects of using the placebo in the studies. There was a noticable difference found between placebo acupuncture and acupuncture denoted by a standardised mean difference of -0.17, which is at 95% confidence interval (-0.26 to -0.08). The difference between placebo acupuncture and no acupunture at all was denoted by a standardised mean difference of -0.42 (-0.60 to -0.23) (Madsen & Gotzsche, 2009). Although some positive effects were shown from the studies regarding placebo acupuncture treatment for pain, it is noted that it had little to no effect in some cases, depending on the origin of the low-back pain and other factors.

Other research findings of a 2007 national survey, including CAM use in the United States, show approximately 3.1 million Americans used acupuncture within that year and pain ranked as 7 out of 10 conditions noted for seeking acupunture treatment, with low-back pain as the most common (NIH-2, 2010). Acupuncture is an effective CAM therapy for patients with chronic low-back pain that is resistent to conventional treatments. Studies show that accupuncture was consistently more effective than conventional treatments for relieving chronic low-back in many cases. Another effective CAM therapy for treating low-back pain is massage therapy, and similar to acupunture, massage therapy works on a mind-body level to relieve pain.

Massage Therapy as a CAM Treatment

According to the Group Health Research Institute, massage therapy proved to be helpful in relieving chronic low-back pain in study participants, as well as improve back function. The study explored short- and long-term effects of massage therapy (including structural and relaxation massage) on chronic low-back pain. It is reported that massage therapy is the most commonly used CAM treatment for back pain (NIH-3, 2011). The study results showed significant improvements in lower back pain and disability in study participants after 10 weeks of massage therapy. “For example, at 10 weeks massage recipients were better able to perform daily activities, were more active, spent fewer days in bed, and used less anti-inflammatory medication than those who received usual care” (para. 4). There are various benefits noted from study results that indicate massage therapy is an effective CAM treatment for low-back pain. For example, the warm, pressured touch of someone’s hands can stimulate relaxation in the mind and muscles, which can contribute to healing and alleviation of low-back pain.

Massage Therapy vs. Placebo

Research results of a 2013 study indicate that massage therapy is more effective for treating low-back pain, compared to placebo in this regard. Massage therapy is a proven safe treatment modality for low-back pain, with little to no signficant side effects or risks. The study considered different types of massage therapy such as Swedish massage, acupressure, Thai massage and other manual massage therapy techniques. Research findings include the results of the use of spinal manipulative therapy to treat non-specific low-back pain in study participants. Reports show low-back pain and disability improvement scores of 0.8 to 2.2 confidence intervals for a 1.5 effect size and confidence intervals of -1.6 to -0.1 for an effect size of -0.9. It is noted this shows that massage therapy is more effective for reducing low-back pain than placebo or no treatment at all. However, it is also noted that massage therapy is not more effective than spinal manipulative therapy (Kumar, Beaton, & Hughes, 2013).

Research findings of other studies show that massage therapy patients often experience immediate relief from symptoms of pain and stiffness. In addition, they experience an increased range of motion along with pain reduction. This is likely associated with increased serotonin levels in the brain for low-back pain patients when undergoing massage therapy, as the body’s natural levels are enhanced. Additionally, research shows that massage therapy also increases dopamine levels in the brain, which stimulate pain reduction (Hernandez-Reif, Field, Krasnegor, & Theakston, 2011).

Research evidence shows that massage therapy is sort of a medicinal treatment, because it sets off chemicals in the brain that serve medicinal purposes. This is particularly promising, since studies also show that low-back pain is difficult to treat. Massage therapy is also a relaxation strategy that contributes to decreasing pain. With massage therapy, the patient can receive deep tissue massage and the benefit of other massage techniques used. In addition, the patient experiences full-body relaxation with theraupetic massage.

Conclusion

Many people understand that one of the best things they can for themselves and their families is taking active roles in their own healthcare and healthcare choices. This is a great motivator for why people seek out alternative CAM therapies such as acupuncture and massage therapy. Most people actively search for better and newer ways of handling their health issues or preventing them from occurring. It is important for people to have options when it comes to their healthcare choices, which is something that is important to them. This is why it is important for the healthcare industry to take steps to cater to what consumers need and want in the areas of health management and treatment, which involves including CAM therapies and interventions with their conventional healthcare offerings, particularly for low-back pain management. This is good because often times, many chronic low-back pain patients get little to no relief from their pain through conventional methods and medications. CAM treatments such as acupuncture and massage therapy have proven positive effects on alleviating low-back pain.

References

Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2011). Lower back pain reduced and range of motion increased after massage therapy. International Journal of Neuroscience, 106(3-4), 131-145.

Kumar, S., Beaton, K., & Hughes, T. (2013). The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews. International Journal of General Medicine, 6(1), 733-741.

Madsen, M. V., & Gotzsche, P. C. (2009). Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ, 338.

Manheimer E., White A., Berman B., Forys K., Ernst E. (2005). Meta-analysis: Acupuncture for low-back pain. Ann Intern Med., 142(8), p. 651-63.

Mayo Clinic Staff. (2012). Back Pain. Retrieved from The Mayo Clinic: http://www.mayoclinic.com/health/back-pain/DS00171/DSECTION=causes

NCCAM. (n.d.). What Is Complementary and Alternative Medicine (CAM)? National Institutes of Health, U.S. Department of Health and Human Services. National Center for Complementary and Alternative Medicine. Retrieved from http://cim.ucdavis.edu/clubs/camsig/whatiscam.pdf

NIH. (2013, May). Complementary, Alternative, or Integrative Health: What’s In a Name? Retrieved from National Center for Complementary and Alternative Medicine: http://nccam.nih.gov/health/whatiscam

NIH-2. (2010). Acupunture for Pain. Retrieved from National Center for Complementary and Alternative Medicine: http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm

NIH-3. (2011). Massage Therapy Holds Promise for Low-Back Pain. Retrieved from National Center for Complementary and Alternative Medicine: http://nccam.nih.gov/research/results/spotlight/070411.htm

NINDS. (2013). Low Back Pain Fact Sheet. Retrieved from National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm

Rooney, L. (2008). Acupuncture in the treatment of non-specific low back pain in an adult population: a review of the evidence. Internet Journal of Advanced Nursing Practice , 9(2), 6.