Acupuncture for lower back pain in primary care
Acupuncture for chronic low back pain has been reimbursed under Medicare in the US since January 21, 2020. Patients will be reimbursed for 12 treatments, with the option to expand to 20. The change is based on strong evidence and a focus on non-opioid pain care.
Since January 21, 2020, acupuncture for lower back pain has been reimbursed in America from Medicare's primary care (federal health insurance for the elderly) — an important development for chronic pain care.
Patients with chronic low back pain (pain longer than 12 weeks) can be reimbursed for up to 12 treatments in 90 days. If improvement is visible, this can be extended with a maximum of 8 additional sessions within one year (up to 20 treatments in total).
This change is the result of growing scientific evidence for the effectiveness of acupuncture for chronic low back pain - and the need to provide safe alternatives to opioid pain medications during the opioid crisis in the United States.
Acupuncture for lower back pain
Studies, such as clinical trials and meta-analyses, are increasingly showing that acupuncture can help with chronic low back pain. In many studies, acupuncture performs better than standard treatment, and with significantly fewer, if any, side effects. The evidence has been around for a long time and has contributed to policy change, so that compensation is now possible for people with chronic complaints.
Research into acupuncture for lower back pain
Research into acupuncture has been difficult in the past due to three challenges:
- previous studies were often not well designed
- compared with placebo
- the mechanism of action was unclear
Nowadays, the studies are of better quality, which makes it possible to bundle results in meta-analyses. In these studies, acupuncture is regularly compared with other treatments such as medication, physical therapy and manual therapy — and acupuncture often comes out positively.
Comparison of effectiveness
For a long time, it was thought that acupuncture mainly had a placebo effect. But because the quality of research systems has improved, this is no longer sustainable. The best way to assess effectiveness is to compare acupuncture with other treatments — and this is increasingly happening with positive results for acupuncture, especially for lower back pain.
Benefits of Acupuncture
Acupuncture offers various benefits for pain symptoms:
- few to no side effects
- strengthens the body and supports self-recovery
- can provide quick relief
- effects can be long-term
- cost-effective treatment
The focus on acupuncture as an alternative to pain medication is related to the opioid crisis: traditional pain medication has side effects and can be addictive. Acupuncture not only reduces pain but also focuses on the functional improvement of the body, so that you can strain it better and better.
Mechanism of action
The exact mechanism of action of acupuncture is not yet fully understood, but several physiological effects have been described in research, including:
- stimulation of the nervous system
- the release of pain-relieving substances (endogenous opioids)
- improved blood flow
- inhibition of inflammatory reactions
- regulation of pain signaling agents such as substance P
- influence on connective tissue
Together, these effects contribute to pain reduction and functional recovery.
Want to read more?
- See how you can support yourself with acupuncture for back pain
- Source: Centers for Medicare & Medicaid Services
