Exercise or acupuncture? Which alternative treatment works best for patients with lumbar spinal stenosis?

Lumbar spinal stenosis (LSS) causes chronic back pain, which is relieved through a variety of treatment methods. In a study published in the journal BMC Complementary and Alternative Medicine, Japanese researchers compared the effectiveness of medication, exercise, and acupuncture – the three most commonly prescribed approaches – for relieving pain caused by LSS.

Back pain is a common affliction among adults, brought about by a number of factors that include wrong posture, stress, and health conditions, among others. LSS is a lower back condition that arises when the spinal nerves are choked (“stenosis” means “choking” in Greek), causing pain. This choking is most often the result of bone degeneration, which is why LSS is almost always age-related and is more common in older individuals.

Young people may also develop LSS in rare cases, either as a result of an injury or from having the wrong spinal curvature. In any case, it’s estimated that about 400,000 Americans suffer from the condition.

Sufferers are generally comfortable in a sitting position, but standing up constricts the flow of blood around the spinal nerve. The result is discomfort which, although tolerable in most cases, often worsens with time. In advanced cases, the pain can be debilitating. Other symptoms of LSS include leg pain and a numb feeling that spreads from the lower back down to one’s buttocks and legs.

Nonsteroidal anti-inflammatory analgesics (NSAIDs) are often prescribed to ease sufferers’ discomfort, but prolonged use of these chemical drugs often come with terrible side effects. Both exercise and acupuncture are considered safe for the elderly, but their effectiveness – especially in the case of exercise – has yet to be established and compared.

To conduct the study, the researchers recruited patients with L5 root radiculopathy associated with LSS who visited Iwai Orthopaedic Medical Hospital between December 2011 and January 2014. The subjects chosen were aged 50 to 79 years. Those who exhibited muscle weakness had uncontrolled diabetes mellitus, or using depressants or psychotropics were excluded from the inquiry.

The patients were randomly assigned to one of three groups: Medication, exercise, and acupuncture. The recruitment continued until the groups had 38, 40, and 41 members respectively.

Those in the medication group were given 900 mg of acetaminophen which they had to take three times a day.

The subjects in the exercise group were given a program that included simple back flexion exercises for the first two weeks. They had to perform six sets of the routine, with each set entailing 10 repeats. The participants were also given information on self-management measures and risk factors for LSS.

Those in the acupuncture group went through treatment with an acupuncturist who had postgraduate training and more than a decade of experience in the practice. They were required to attend five sessions every month, twice during the first week and once from week two to week four. The needles were applied to acupuncture points BL-23 (Shenshu), BL-25 (Dachangshu), BL-5 3(Hoko), BL-54 (Zhibian), BL-40 (Weizhong), GB-34 (Yanglingquan), and BL-57 (Shengshan). (Related: Acupuncture Proven to have an Effect beyond Placebo, Harvard Study Concludes.)

All three groups were given access to specific pain relievers as needed, except on the day before and during efficacy evaluation.

To evaluate the participants’ comfort levels, the researchers had the patients fill out a Zurich claudication questionnaire (ZCQ) before the treatment and four weeks after.

What they found was that acupuncture led to improvements both in the severity of the patients’ symptoms and their physical function, leading to higher satisfaction rates. Medication and exercise, on the other hand, caused improvements only the severity of the symptoms. The participants were also less satisfied with the two compared to acupuncture.

To the researchers, their findings provided ample proof of the effectiveness of acupuncture in providing pain relief to sufferers of LSS.

For more stories on the benefits of acupuncture, go to ChineseMedicine.news.

Sources include:

Science.news

Spine-Health.com