Chronic low back pain has a way of creeping into your day-to-day life — it affects how far you walk, how long you sit, even whether you say yes to plans. For older adults, those limits can make them feel as if they’re slowly losing their independence. In 2020, low back pain impacted 619 million individuals,1,2 making it the single cause of disability worldwide.3
Unfortunately, while the problem is common worldwide, so is the mistreatment of it. Chronic back pain is also a leading cause of opioid addiction. Studies show that individuals prescribed opioids for musculoskeletal issues, particularly spinal and lower back pain, have higher rates of opioid misuse and addiction compared to other pain categories.4 This reality leaves people asking: Is there a safer, drug-free alternative that works?
Acupuncture has been recognized as helpful for chronic back pain in peer-reviewed Western medical literature since at least the late 1990s, with institutional endorsement steadily growing since then.5
Ancient Chinese medical texts documented acupuncture use for pain, including back pain, over 2,000 years ago, but modern clinical studies and guidelines supporting its effectiveness for chronic low back pain appeared after the 1997 National Institutes of Health (NIH) consensus statement6 recognized the evidence base for pain management, including chronic back pain. So what does the research reveal about this traditional pain remedy?
A Landmark Study Shows Acupuncture Delivers Lasting Relief
To determine whether acupuncture could offer meaningful relief for older adults suffering from chronic low back pain, researchers from Kaiser Permanente, RAND Corporation, and other institutions recently conducted a large-scale randomized clinical trial. Funded by the NIH through its Helping to End Addiction Long-term (HEAL) initiative and published in JAMA Network Open, the study aimed to inform Medicare7 coverage decisions by evaluating acupuncture’s long-term effectiveness and safety.8
• The study enrolled 800 adults aged 65 and older with chronic low back pain — Participants were randomly assigned to one of three groups: usual medical care (UMC), standard acupuncture (SA), or enhanced acupuncture (EA),9 which included additional sessions beyond the standard course. SA consisted of eight to 15 sessions over 12 weeks, while EA added four to six more sessions in the following 12 weeks.10
• Acupuncture significantly reduced pain-related disability — At both six and 12 months, participants in the SA and EA groups reported greater improvements in back pain-related function11 compared to those receiving usual care.12 These improvements included better mobility, reduced pain intensity, and enhanced ability to perform daily tasks, such as walking and bending.
“We saw consistent and meaningful improvements in pain-related disability across both acupuncture groups,” said Dr. Lynn DeBar, lead investigator from Kaiser Permanente Center for Health Research.13
• Emotional and psychological benefits were also taken into consideration — Anxiety symptoms were notably reduced in both acupuncture groups, and participants reported feeling more positive about their overall pain management.14 However, there were no significant differences between SA and EA in terms of disability reduction.
• The treatment proved safe and well tolerated — Serious adverse events were rare and comparable across all groups. Minor side effects, such as discomfort at needling sites, were reported by fewer than 10% of acupuncture participants. Importantly, over 80% of participants completed the minimum recommended number of sessions, demonstrating high adherence.
• The benefits were sustained over time — Beyond short-term relief, the study demonstrated that acupuncture’s positive effects on pain-related disability were not fleeting. According to the study authors:15
“The relative benefit of acupuncture compared with usual medical care on disability persisted at 12 months. These findings suggest that acupuncture needling is an effective and safe treatment option for older adults with CLBP [chronic low back pain].”
The results of this trial underscore acupuncture’s capacity as a safe, effective, and sustainable treatment for chronic low back pain in older adults. But to fully appreciate its role in modern medicine, it’s worth exploring its origins, innovations, and why its principles continue to resonate in contemporary healthcare.
A Deep History of Acupuncture Across Cultures
Acupuncture is far more than a modern wellness trend — its origins stretch to ancient civilizations. While Traditional Chinese Medicine (TCM) gave structure to its principles, acupuncture-like techniques have appeared in cultures around the world for thousands of years.
Central to TCM is the concept of Qi (pronounced “chee”) — a vital life force that flows through the body’s energy channels, or meridians. There are 14 major meridians,16 each connecting organs, tissues, and cells. When Qi flows freely, the body is in balance; but when it’s blocked or disrupted, pain and illness can occur. Acupuncture aims to restore this flow, allowing the body to enhance overall wellness.17
• The earliest written record comes from China — The Yellow Emperor’s Classic of Internal Medicine, called Huangdi Neijing, not only codified acupuncture theory but also laid the groundwork for its integration into broader medical practice. Attributed to Emperor Huang Di, who reigned between 2696 and 2598 BCE, it outlines the theory of meridians and Qi and remains central to TCM today.
• Stone-age tools support acupuncture’s early use — Long before the invention of metal needles, Neolithic Chinese practitioners used sharpened stones known as bian to stimulate specific points on the body. These tools were used to relieve pain, drain abscesses, and promote healing. Their existence suggests that the therapeutic principles behind acupuncture — targeted stimulation to restore balance — were already in practice thousands of years ago.18
• Acupuncture-like practices appeared across ancient civilizations — In Egypt, the Ebers Papyrus (circa 1550 BCE) describes a network of vessels and channels that closely resembles the Chinese meridian system. Similar healing philosophies emerged in Persia, India, and South America, where practitioners used pressure, heat, and puncture techniques to influence the body’s internal energy flow.
These parallels suggest that the concept of energy-based healing may have developed independently across cultures.19
• Indigenous groups used similar techniques — North American Indians and Eskimos reportedly used sharpened stones to treat illness, suggesting that energy-based healing methods were not exclusive to Asia.20
• A prehistoric European link was discovered in 1991 — The mummified remains of a 5,000-year-old man, more popularly known as Otzi the Iceman, were found in the Alps between Austria and Italy. His body bore tattoos located directly on — or within 6 millimeters of — traditional acupuncture points, indicating that acupuncture-like practices have existed in prehistoric Europe.
• Acupuncture’s principles spread and evolved — Through centuries of cultural exchange, acupuncture traveled along the Silk Road and was adopted in Korea, Japan, and Vietnam. Each region adapted the practice to its own medical philosophies while preserving the core principles of Qi, meridians, and energetic balance.
By the 17th century, European physicians such as Willem ten Rhijne began documenting acupuncture techniques, paving the way for its eventual integration into Western medicine.21,22
Acupuncture Unlocks Your Body’s Ability to Heal
Pain is often a symptom of deeper dysfunction — poor circulation, inflammation, stress, or blocked energy flow. Acupuncture addresses these root causes by stimulating the body’s own healing mechanisms. After exploring acupuncture’s cultural and historical evolution, it’s important to understand how it works in the body, not through philosophy but through biology.
• Nerve stimulation and signal transmission — Acupuncture stimulates skin nerves, which send signals to the brain and spinal cord. These signals travel through the peripheral nervous system to the spinal cord and brain, where they influence how pain is processed and perceived.23
• Release of pain-modulating chemicals — Acupuncture prompts the release of endorphins, enkephalins, and dynorphins, which act as natural opioids to reduce pain.24
• Inflammation control and immune modulation — Acupuncture affects the production of cytokines, which are proteins that regulate immune response. It reduces pro-inflammatory cytokine levels while increasing anti-inflammatory cytokines, helping the body manage chronic pain and tissue stress.25,26
• Reduces pain by boosting nitric oxide (NO) — When acupuncture is performed using proper technique, specifically by eliciting de qi, a sensation described as a dull ache or mild electric shock, it triggers the release of NO at the acupuncture site.27 This mechanism aligns with findings from earlier dermal microdialysis studies, which found that electroacupuncture led to elevated NO at nearby acupoints.28
A 2017 review published in the Chinese Journal of Integrative Medicine that consolidated findings from multiple experimental studies also showed that acupoints consistently exhibit higher levels of NO signaling molecules than surrounding skin, especially when stimulated with manual acupuncture or low-frequency electroacupuncture.29
• Alters brain activity to reduce pain — Modern imaging techniques have revealed that acupuncture affects how the brain processes pain. In a study published in Human Brain Mapping, researchers using functional magnetic resonance imaging (fMRI) found that acupuncture deactivates regions of the limbic system, such as the amygdala, hippocampus, and anterior cingulate gyrus — areas closely linked to emotion and pain perception.
This calming effect helps explain why patients often report reduced pain and improved mood after treatment. Sham acupuncture, a control method where needles are placed superficially or at non-acupoints, did not produce the same neurological changes, confirming that acupuncture’s impact is specific and measurable.30
• Stimulates the body’s natural healing systems — According to the 2003 World Health Organization’s (WHO) review of clinical trials, acupuncture influences the body in several ways:31
◦ It stimulates electromagnetic signals that release immune cells or pain-relieving chemicals.
◦ It activates the body’s natural opioid system, helping reduce pain and promote sleep.
◦ It engages the hypothalamus and pituitary glands, which regulate many bodily systems.
◦ It alters the secretion of neurotransmitters and neurohormones, positively influencing brain chemistry.
Together, these effects show that acupuncture is more than just needlework — it’s a complex, multi-system therapy that helps the body heal itself.
A Drug-Free Approach to Pain Relief
One of the most significant advantages of acupuncture is its capacity to be a drug-free method for managing pain. Unlike medications that often come with side effects, dependency risks, or diminishing effectiveness over time, acupuncture works by stimulating the body’s own healing mechanisms.
• Outperforms placebo and rivals drug efficacy — According to the WHO’s analysis of clinical trials, acupuncture relieves chronic pain in 55% to 85% of cases — comparable to morphine’s 70% success rate and far exceeding the placebo effect (30% to 35%). These benchmarks highlight acupuncture’s ability to deliver meaningful, drug-free relief.32
• Proven effective for osteoarthritis — One of the most well-documented applications of acupuncture is for osteoarthritis, particularly of the knee. A landmark phase III clinical trial, funded by the NIH and published in the Annals of Internal Medicine journal, enrolled 570 patients diagnosed with knee osteoarthritis to investigate whether acupuncture helps ease their pain.33
None of the participants had prior acupuncture experience, recent knee surgery, or steroid injections. Over 26 weeks, they were randomly assigned to one of three groups — real acupuncture, sham acupuncture, or self-care strategies recommended by the Arthritis Foundation. By week 8 and again at week 14, significant differences began to emerge.
At the end of the trial, the group receiving real acupuncture reported a 40% reduction in pain and a 40% improvement in joint function, compared to baseline assessments. These results were 33% better than the sham acupuncture group, confirming that the effects were not placebo-driven.
The study was praised for its rigor and scale. The late Dr. Stephen E. Straus, the founding director of the National Center for Complementary and Alternative Medicine (NCCAM) at the NIH, stated:34
“For the first time, a clinical trial with sufficient rigor, size, and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee. These results also indicate that acupuncture can serve as an effective addition to a standard regimen of care and improve quality of life for knee osteoarthritis sufferers.”
• Backed by large-scale research — In 2012, the Acupuncture Trialists’ Collaboration analyzed data from 29 randomized controlled trials involving 17,922 patients. The study, which was published in JAMA Internal Medicine, found that acupuncture led to a 50% reduction in pain, significantly outperforming both sham treatments and standard care.35
Dr. Andrew J. Vickers, Ph.D., a biostatistician and attending research methodologist at Memorial Sloan Kettering Cancer Center in New York, and the study’s lead author, concluded:36
“The effects of acupuncture are statistically significant and different from those of sham or placebo treatments … so, we conclude that the effects aren’t due merely to the placebo effect.”
• Supports healing of other conditions — Chronic pain is just one of the many conditions that acupuncture is known to help with. The WHO recognizes its effectiveness in treating other health issues, such as:37
| Neurological and pain-related conditions | Internal and digestive disorders | Women’s reproductive health | Other conditions |
|---|---|---|---|
| Headaches | Dysentery, acute bacillary | Dysmenorrhea | Allergic rhinitis (including hay fever) |
| Facial pain (including craniomandibular disorders) | Epigastralgia (peptic ulcer, gastritis, gastrospasm) | Induction of labor | Depression (including depressive neurosis and post-stroke depression) |
| Neck pain | Biliary colic | Malposition of fetus | Adverse reactions to radiotherapy and/or chemotherapy |
| Knee pain | Renal colic | ||
| Sciatica | Morning sickness | ||
| Stroke | Leukopenia | ||
| Tennis elbow | Hypertension | ||
| Sprain | Hypotension | ||
| Rheumatoid arthritis | Nausea and vomiting | ||
| Pain in dentistry (including dental pain and temporomandibular dysfunction) | |||
| Postoperative pain |
Incorporating Acupuncture in Your Life
If you’re struggling with low back pain, acupuncture is a safe and effective way to find relief — but it’s not a DIY remedy. Treatment should be administered by a certified practitioner in a clean, clinical setting using sterile, single-use needles. With the right guidance, it can fit smoothly into your routine, wherever you are. Below are clear, actionable steps to help you get started safely.38
• Talk to your primary physician first — They’ll assess your medical history, medications, and any chronic conditions to ensure acupuncture is safe for you. This is especially important if you are pregnant, have cancer or a bleeding disorder, or are taking blood thinners.
• Choose a licensed practitioner — If you’re in the U.S., look for the credential LAc, which stands for licensed acupuncturist. This indicates the practitioner has passed the National Certification Commission for Acupuncture and Oriental Medicine exam or met state licensing requirements. Outside the U.S., check with local health boards or traditional medicine councils for certified professionals.
• Know what happens during a session — A typical appointment lasts 60 to 90 minutes. It starts with a discussion of your symptoms and goals, followed by 30 to 40 minutes of needling.
• Understand that results vary — Some people feel relief after one session; others need several treatments. You might feel relaxed, tired, or energized, and notice changes in sleep, digestion, or mood. These responses are normal and reflect how your body uniquely reacts to the treatment.
For more information on this technique, I recommend reading “Study Reveals Previously Unknown Mechanism Behind Acupuncture’s Ability to Reduce Pain.”
Other Smart, Non-Drug Ways to Ease Chronic Pain
Pain relief doesn’t immediately require a prescription. In many cases, nutrition, movement, and targeted therapies can offer meaningful results — supporting your body’s natural healing processes without the risks of long-term medication use. Below are five safe and effective options that complement your current treatment plan and help you manage pain more holistically. If acupuncture isn’t available to you, consider exploring these alternatives:
• Curcumin — This potent anti-inflammatory compound found in turmeric has been shown to reduce joint pain and improve mobility, especially in people with osteoarthritis.39 Curcumin works by blocking inflammatory pathways and suppressing proteins that trigger swelling. For more herbal remedies for chronic pain, read “An Herbal Guide to Natural Pain Relief.”
• K-Laser therapy — This class 4 infrared laser therapy penetrates deep into tissues to reduce inflammation and accelerate healing. It’s particularly effective for injuries and chronic musculoskeletal pain, and helps reduce the need for painkillers.
• Chiropractic care — Chiropractic adjustments help realign the spine and relieve pressure on nerves, which can ease pain and improve mobility. It’s a safe, well-researched option for low back pain and neck stiffness.
• Meditation and mindfulness — Mindfulness-based practices like focused attention meditation can significantly reduce pain intensity. These techniques work in altering how the brain processes pain, offering relief with almost no side effects.
• Massage therapy — A large-scale review published in Pain Medicine analyzed 67 studies on massage for various types of pain, including muscle and bone pain, headaches, fibromyalgia, and spinal cord pain.
The findings showed that massage therapy consistently relieved pain more effectively than no treatment, remained beneficial even when compared to acupuncture and physical therapy, and improved anxiety and overall quality of life with minimal side effects.40
• Emotional Freedom Techniques (EFT) — This self-help method involves gently tapping on specific acupuncture meridian points with your fingertips while speaking affirmations. This process helps release emotional tension, calm the nervous system, and restore balance to the body’s energy flow.
• Building healthy habits to help ease pain — Choosing a healthy lifestyle not only supports the benefits of acupuncture but also helps ease your pain burden. Simple changes in diet, movement, and mindfulness can reduce inflammation, ease pain naturally, and help you build long-term habits for healing and resilience.
◦ Keep your intake of linoleic acid (LA) below 5 grams a day to minimize inflammation and mitochondrial dysfunction. LA-rich cooking oils include canola oil, soybean oil, corn oil, safflower and sunflower oils. Swap these for healthy saturated fats like butter, ghee, tallow or coconut oil instead.
Also avoid processed foods made with LA-rich oils, restaurant foods cooked in them, as well as non-organic chicken and pork. These meats tend to be high in LA thanks to the animals being fed LA-rich grain feed.
◦ Also cut back on grains and refined sugars to lower inflammation and reduce pain triggers.
◦ Add high-quality omega-3 fats like krill oil or wild-caught fish, like Alaskan salmon, to support anti-inflammatory processes.
◦ Get regular sun exposure to naturally boost vitamin D, which helps reduce pain and supports immune function. For a guide on safe sun exposure, review my recommendations in this article.
For far too long, chronic low back pain has been managed with “easy” and temporary fixes — pills that mask symptoms, expensive therapies that only bring brief temporary relief, and costly surgeries that don’t always promise lasting results. Acupuncture offers something different — a natural and evidence-based way to support the body’s ability to heal.
The real power of acupuncture comes from integration — combining it with movement, strength training, and ongoing care to create a complete strategy for long-term health. By taking an active role in treatment and working with professionals, you can shift from simply coping with pain to reclaiming your life.
Frequently Asked Questions (FAQs) About Acupuncture and Back Pain
Q: Is acupuncture only for pain?
A: While acupuncture is best known for treating pain, it can also help with other concerns such as nausea from chemotherapy, stress, digestive issues, headaches, and insomnia. Its holistic nature means it can address a wide range of symptoms, not just physical discomfort.
Q: How does acupuncture work from a Western perspective?
A: Western science explains acupuncture through the nervous system and circulation. The insertion of fine needles stimulates nerves and tissues, increasing blood flow and prompting the body to release natural pain-relieving chemicals like endorphins. It can also reduce inflammation by boosting compounds like adenosine, which calms irritated nerves and tissues.
Q: How many sessions are needed to see results?
A: The number of sessions varies depending on the individual and the severity of the condition. Some people feel relief after just a few visits, while others notice gradual improvement over several weeks. Consistency is key, and many treatment plans involve eight to 15 sessions spread out over three months.
Q: Is acupuncture safe for older adults?
A: Yes, acupuncture has a strong safety record when performed by a licensed professional. Because it is non-invasive and drug-free, it poses fewer risks than many conventional treatments. Most reported side effects are mild, such as slight bruising or soreness at the needle sites, and they usually resolve quickly.
Q: Can acupuncture be combined with other treatments?
A: Absolutely. Acupuncture works well alongside other therapies like physical therapy, prescribed medications, or exercise. It is considered a complementary approach, meaning it adds to your current care plan rather than replacing it. Always discuss your full health history with both your doctor and your acupuncturist to ensure treatments work well together.
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