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  Acupuncture relieves back pain: study
Acupuncture brought more relief to people with back pain than standard treatments, whether it was done with a toothpick or a real needle, say US researchers.

But the study, which appears in the Archives of Internal Medicine, raises new questions about how acupuncture works.

"Our study shows that you don't need to stick needles into people to get the same effect," says Dr Daniel Cherkin of Group Health Center for Health Studies in Seattle, who led the study.

"Historically, some types of acupuncture have used non-penetrating needles. Such treatments may involve physiological effects that make a clinical difference," says Dr Karen Sherman, who worked on the study.

The team, wanted to study the effects of different types of acupuncture in a large, carefully controlled study of 638 patients with chronic low back pain.

They divided patients into several groups. One received seven weeks of standardised acupuncture treatment known to be effective in back pain. Another group got an individually prescribed acupuncture treatment.

A third group was treated using a toothpick in a needle guide tube that did not pierce the skin as regular acupuncture does, but targeting the correct acupuncture points.

A fourth group received standard medical treatment, which included medication and physical therapy.
Long-lasting

After eight weeks, 60% of the patients who received acupuncture of some form reported significant improvement in their ability to function compared 37% of those who got standard medical care alone.

For many patients, the improvement lasted for a year, they write.

But there was no significant difference in the pain relief people got from the acupuncture using needles or from toothpicks.

The researchers say there is some evidence that needles were used 2000 years ago in acupuncture treatment, and some imaging studies have shown that "superficial and deep needling of an acupuncture point elicited similar blood oxygen level-dependent responses."

Another study found that lightly touching the skin can induce some emotional and hormonal reactions, which could explain the benefit, they write.

Or, it may simply be the experience of visiting an acupuncturist for treatments that helps.

Regardless of how it worked, they say acupuncture appears to be a relatively safe and painless way of easing an aching back, especially when traditional medicine alone fails.

But a review of 13 trails published in the British Medical Journal in January 2009, found a small analgesic effect, but was unable to attribute it to acupuncture.

The authors said, "whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.
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