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A number of complementary and alternative treatments are used to relieve back pain. Complementary means it is used together with conventional medicine. Alternative means it is done in place of conventional medicine.
Acupuncture is now a common alternative treatment for certain kinds of pain. It involves inserting small needles or exerting pressure on certain "energy" points in the body. When the pins have been placed successfully, the patient is supposed to experience a sensation that brings a feeling of fullness, numbness, tingling, and warmth with some soreness around the acupuncture point. Unfortunately, rigorous studies of acupuncture are difficult to perform, and most evidence on its benefits is weak. In any case, it may be specifically helpful for certain patients with back pain, such as pregnant women, who must avoid medications. Anyone who undergoes acupuncture should be sure it is performed in a reputable location by experienced practitioners who use sterilized equipment.
Acupuncture has not shown any benefits for acute low back pain in most patients, but may provide some help for patients with chronic low back pain.
Some studies have shown that massage therapy can help some patients with chronic or acute back pain, especially when combined with exercise and patient education.
Some studies report that a course of cognitive-behavioral therapy helps reduce chronic back pain, or at least enhances the patient's ability to deal with it. The primary goal of this form of therapy in such cases is to change the distorted perceptions that patients have of themselves, and change their approach to pain. Patients use specific tasks and self-observations to help them change their thinking. They gradually shift their perception of helplessness against the pain that dominates their lives into the perception that pain is only one negative among many positives and, to a degree, a manageable experience.
Chiropractors typically perform spinal manipulations, but so do osteopathic doctors.
Spinal Manipulation for Uncomplicated Low Back Pain.
There is evidence of benefit for spinal manipulation treatment of subacute pain and exacerbations of chronic pain. Ongoing or maintenance spinal manipulation has not been proven to alter the course of chronic back pain.
Mild and temporary side effects from spinal manipulation are common. The potential for serious adverse effects from low back manipulations is low.
Some chiropractors may take a lot of x-rays, particularly those of the full spine, which may have long-term harmful consequences. Patients should also be aware that some chiropractors use alternative treatments that have not been proven or rigorously studied. All patients should require objective evidence on the benefits of their treatments.
Percutaneous Neuromodulation Therapy. A technique called percutaneous neuromodulation therapy (PNT) uses a small device that delivers electrical stimulation to deep tissues and nerve pathways near the spine.
Electrical Nerve Stimulation. Transcutaneous electrical nerve stimulation (TENS) uses low-level electrical pulses to suppress back pain. A variant of this procedure, percutaneous electrical nerve stimulation (PENS), applies these pulses through a small needle to acupuncture points.
When tested in high-quality studies, electrical nerve stimulation has not been found to provide much help.
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