Those who suffer from chronic back pain often receive medication and physiotherapy. But a new study now shows that additional acupuncture appointments relieve the pain even more effectively-even in people over 65 years. The researchers therefore recommend that acupuncture treatment also offer older people by default through the state health insurance. However, the study design also raises questions.
Chronic back pain is widespread and the main reason that people are restricted in their movements. In the United States alone, more than a third of the older adults suffer permanently from the lower back pain. To alleviate this, pain relievers and physiotherapy are usually prescribed, which, however, only help to a limited extent. Some patients also receive acupuncture – stimulation of special trigger points in the skin through fine needles. This treatment based on Asian traditions is controversial and according to some studies acupuncture does not work better than placebo treatment. Nevertheless, there is evidence that acupuncture in middle -aged people works well against back pain. The effect in the elderly has not yet been examined.
Acupuncture also for older pain patients?
This has now made up for researchers around Lynn Debar from the Emperor Permanent Center for Health Research in Portland. They carried out a clinical study with 800 participants over the age of 65 from the United States, which had suffered from back pain for at least three months. The test subjects either only received medication or additional acupuncture. One group was given the usual eight to 15 needle treatments over three months, which was planned for health care. A second group received another four to six acupuncture appointments in the three following months. During the test period, the test subjects should state after three, six and twelve months how well these pain measures helped them. To do this, they filled out a questionnaire to typical movements in everyday life as well as other questionnaires to the common symptoms such as pain, depression and fears.
The evaluation showed that the test subjects who also received acupuncture reported after six and twelve months of lower pain, less movement restrictions and less fear than those who had only received the usual medical care. “We found that the extent of this acupuncture effect was modest, but was positive and sustainable,” reports Debar. These findings confirm that stimulation through needles works and show that acupuncture relieves chronic back pain even in older patients. However, whether the treatment was over three or six months made no difference. Accordingly, a temporary, shorter acupuncture treatment duration is sufficient to relieve the pain.
Needle therapy should become a medical-safe standard
In view of these results, the team led by Debar recommends that the acupuncture for pain therapy also offer and pay older people through state health insurance by default in order to facilitate access to this treatment. The researchers did not observe findings that comply with it. “We saw very few side effects during the clinical study,” reports senior author Andrea Cook from Emperor Permanent Washington Health Research Institute in Seattle. Most of the participants only reported slight pain at the injection sites.
In addition, acupuncture does not pose the risk of interactions with medication that patients often take in addition to the pain relievers: “In addition to back pain, older adults often also have to struggle with other medical problems. Acupuncture offers a less invasive option that has a better security profile than many of the usual treatments for back pain in older adults.”
However, the study design also raises questions: Because the patients of the two acupuncture groups also received this needle, but the control group did not have any corresponding sham treatments, a placebo control is missing. Therefore, the researchers cannot rule out that the positive effect of acupuncture in their patients is based on the placebo effect – the unconscious expectation of the test subjects that this additional treatment will help them. Especially in pain therapy, this effect can be responsible for a third of the determined effect.
Source: Lynn Debar (Emperor Permanent Center for Health Research) et al.; Jama Network Open, DOI: 10.1001/Jamanetworkkopen.2025.31348
