Recent studies have highlighted the effectiveness of acupuncture, particularly when combined with core muscle exercises, in treating chronic nonspecific low back pain (CNLBP). This condition, affecting millions worldwide, often results in significant pain and disability. Acupuncture, a non-pharmacological intervention, has proven to reduce pain severity and improve functional outcomes, offering a viable alternative to conventional therapies.

Acupuncture Techniques and Protocols

In a 2024 systematic review involving 727 patients across 11 randomized controlled trials, the combination of acupuncture with core muscle exercises led to substantial improvements in pain scores, assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) for functional capacity. The study utilized 0.25 mm x 40 mm needles, targeting acupoints such as BL23 (Shenshu), GV4 (Mingmen), GB30 (Huantiao), and ST36 (Zusanli). Needles were inserted at depths of 10-20 mm, depending on the patient’s muscle mass, with needle retention for 30 minutes per session. [1]

 

Each acupuncture session involved manual manipulation to achieve deqi, a sensation indicative of effective needle stimulation. Treatments were conducted twice weekly for eight weeks, providing consistent pain relief and improved mobility in patients with CNLBP. This approach helped regulate muscle tone and reduce pain sensitivity through the modulation of neural pathways. 

Mechanisms and Biomedical Findings

Acupuncture’s efficacy in CNLBP has been linked to its impact on inflammatory mediators and neuromodulation. Studies found that acupuncture significantly lowered levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in serum, markers associated with inflammation. MRI data further revealed changes in the activation of pain-related brain regions, including the prefrontal cortex and insula, suggesting that acupuncture helps regulate the central processing of pain. [2] [3]

 

Electroacupuncture for Enhanced Results

Electroacupuncture (EA) was another key method evaluated in these studies, offering additional benefits over manual techniques. EA was administered using 2 Hz electrical stimulation to needles placed at BL23 and GV4, with sessions lasting 30 minutes. The electrical stimulation was found to enhance the release of endorphins and promote better pain management in CNLBP patients.

 

Recent video on post-op acupuncture:

 

Practical Application and Frequency of Care

Based on the research, the following protocol can be recommended:

 

• Acupoints: BL23, GV4, GB30, ST36.

• Needle Specifications: 0.25 mm x 40 mm needles.

• Depth of Insertion: 10-20 mm, adjusted based on the patient’s muscle thickness.

• Retention Time: 30 minutes per session.

• Technique: Manual manipulation until deqi, or electroacupuncture with 2 Hz stimulation.

• Frequency: 2 sessions per week for 8 weeks.

 

This combination of manual and electroacupuncture has demonstrated improvements in pain scores and functional capacity, making it a reliable choice for managing chronic low back pain without the adverse effects associated with pharmacological treatments.

 

Conclusion 

Acupuncture’s role in managing chronic nonspecific low back pain is supported by recent clinical evidence, demonstrating its potential to reduce pain, lower inflammation markers, and improve overall function.

 

Sources

1. “Clinical efficacy of acupuncture therapy combined with core muscle exercises in treating patients with chronic nonspecific low back pain: a systematic review,” Frontiers in Medicine, April 2024.

2. “Effect of electroacupuncture on chronic low back pain and related biomarkers,” Journal of Pain Research, 2024.

3. “Meta-analysis of acupuncture’s role in reducing inflammation markers in chronic pain,” BMC Complementary Medicine, 2024.