Acupuncture for Pediatric Back Pain
Pediatric spinal conditions, including scoliosis and neurofibromatosis, can be challenging to treat, especially given the high risk profiles of pain medications and surgical procedures. Acupuncture, an ancient Eastern practice, was studied by Johnson et al as a form of integrative medicine for pain management, and it appears to be noticeably beneficial for younger patients suffering from spine-related disorders.
A team of doctors at an integrative medical center in Chicago, Illinois, recently conducted a single-arm feasibility study to assess the effects of a standard acupuncture trial on young patients. Fifty-five patients (69% female; ages 5-20) took part in the study, presenting a diverse array of pain problems. A majority of the issues were musculoskeletal (75%), including spinal conditions like scoliosis, rheumatoid arthritis (or juvenile idiopathic arthritis), Chiari malformation, neurofibromatosis, and sports injury.
The patients were scheduled to receive 8 standard acupuncture sessions. By the end of the first session, patients reported a significant drop in pain scores, which progressively improved with every subsequent treatment. Pain was not the only symptom analyzed in the study, though. Using the Pediatric Nausea Assessment (PeNAT), patients reported a similarly significant reduction in nausea starting from the first treatment, which continued to improve through to the eighth treatment. This progressive reduction indicated lasting lower levels of nausea, and not surprisingly, Quality of Life Inventory (PedsQL 4.0) data showed similar improvements.
"Patients reported significant reductions in health, emotional, social, and educational problems. These findings were corroborated by similar reductions in parent-reported observations of the same issues," the authors wrote.
Only 56.4% of the patient group were able to complete all 8 treatment sessions. However, no adverse events occurred during the trial. Absences were more largely due to difficulties traveling to the acupuncture center, scheduling with school/work obligations, and illness-related complications. Four patients died from their diseases during the trial.
"This study contributes to the sparse literature on the use of acupuncture in a pediatric population, and supports acupuncture's feasibility as an effective strategy for managing chronic pain," the authors stated.
Treating Spinal Conditions with Acupuncture
Nicole Heuschkel, LAc, a licensed acupuncturist who works at the Monmouth Pain and Rehabilitation Center in Red Bank, New Jersey, described her own successes in treating pain conditions using acupuncture therapy. "As always, every patient is recommended a treatment protocol based on their individual needs and severity. With a spinal condition, like rheumatoid arthritis, there is an increased amount of inflammation within the body."
"The effects of acupuncture are cumulative and by doing frequent treatments back-to-back or closely grouped together, it acts like a kick-start to realign the body's energy. The person will gain more momentum in their healing process." Typically, as patients improve, they taper down the frequency of treatments and perhaps remain on a maintenance plan or an as-needed basis of treatment.
When treating spinal conditions, Ms. Heuschkel looks for the problem areas that form the basis of a patient's discomfort. Pain and stress are not mutually exclusive symptoms, so often times, targeting a specific region correlates to both pain and stress relief.
"In Eastern Medicine, each level of the spine correlates to an organ and function. Essentially, both (pain and stress) can be treated together. Assessing the location of a slipped disc or damaged vertebrae can actually guide the practitioner to where there may be an imbalance or weakness internally within the body."
Acupuncture: Ancient Practice in Modern Medicine
Despite the positive evidence for acupuncture's benefits to managing spine-related pain, there is still notable skepticism over the real medical value of the practice. The technique's origins in philosophic concepts of yin and yang may lead some to question the true medical mechanism that explains acupunctures documented success in treating pain and other symptoms.
Acupuncture centers its philosophy on the idea that pathways of natural energy, or Qi, in the body must be freed up. These pathways, referred to as "meridians," can be unblocked through stimulating acupoints with needle stimulation. The idea is that the needle stimulation restores the nerves to a healthier state, thus reducing nociception.
However, some research alleges this could be more due to a placebo effect than anything else, as studies commonly have found there to be no discernible difference in efficacy between acupuncture and sham acupuncture treatments.1,2 Regardless, as further investigations show acupuncture is effective as an integrative medicine for the treatment of painful conditions, doctors may consider utilizing the practice as a viable pain management option, especially given its low-risk credentials.3,4
"Because we're not injecting anything into them, it's working with the body's natural energy, so there are very few precautions we have to consider," said Nicole Heuschkel, Lac, a licensed acupuncture therapist at Monmouth Pain and Rehabilitation Center in Red Bank, New Jersey. Heuschkel has been practicing acupuncture for four years and notes that many times, pediatric patients actually respond to treatments much faster than adults.
And while there are some contraindications to consider with acupuncture therapy, such as joint replacements, pacemakers, or heart conditions, which generally do not affect children, acupuncture is a low-risk treatment option. There can be a real challenge with getting young children to be comfortable with the needles used in the therapy, however. Because of this, trained acupuncturists like Heuschkel use simple techniques to ease children into the process, starting off with more noninvasive techniques, like acupressure.
Angela Johnson, Dipl OM, LAc, MSTOM, MPH, lead author of the study, similarly has had success using a careful approach with the patient. "I really had to be creative about building their trust. Oftentimes instructing patients to visualize how they want to improve their health helps them feel positive about reaching their goals and becoming healthier," Johnson said.
The study was supported by a grant provided by Rush University's Medical Center Women's Board. The authors reported no conflicts of interest. The study abstract can be viewed here.