Large trial finds acupuncture eases chronic lower back pain in over‑65s

A randomized clinical trial published in JAMA Network Open found that acupuncture produced greater improvements in chronic lower back pain and related disability in adults aged 65 and older than usual medical care alone, with benefits that persisted for at least 12 months.

Researchers at Kaiser Permanente in Oregon and collaborators across three other major U.S. health systems assigned older patients with long‑term lower back pain to one of three groups: usual medical care, a standard course of acupuncture on top of usual care, or the same acupuncture course followed by periodic maintenance sessions. The standard regimen consisted of eight to 15 acupuncture sessions delivered over 12 weeks; the maintenance arm received four to six additional sessions over the subsequent 12 weeks.

At the primary six‑month time point, both acupuncture groups showed significantly greater improvements in back‑pain disability scores than the group receiving usual care. On a 24‑point scale used to measure how pain limits daily life, patients who received acupuncture were on average about 1.0 to 1.5 points better off than those receiving usual care. Nearly half of patients in the acupuncture arms reported at least a 30 percent reduction in symptoms, compared with roughly 30 percent in the usual care group.

The researchers reported that the improvements were sustained at 12 months from the start of treatment, even when no further acupuncture was provided after the initial course. Adding maintenance sessions produced a modest additional improvement on pain ratings but did not materially change overall disability scores.

Safety data showed that serious adverse events were rare and occurred at similar rates across groups. Only one case—an infection of the leg that responded to antibiotics—was judged possibly related to acupuncture. Minor problems such as brief soreness at needle sites occurred in fewer than one in 10 patients.

Back pain is the world’s leading cause of disability and a common reason for primary care visits. In Britain, back pain accounts for an estimated three to seven million general practitioner appointments annually; NHS figures indicate musculoskeletal problems constitute nearly a third of GP consultations. Standard treatments often include pain medications, spinal injections or surgery, but pharmacologic therapies can have modest benefits and carry higher risks for older adults, including stomach bleeding, confusion and dependence.

Acupuncture is a drug‑free option that is already available in private clinics and in some National Health Service and U.S. health‑system settings, and it appears in clinical guidance for managing long‑term back pain in the U.S. and U.K. This trial is the first large randomized study focused exclusively on adults 65 and older and was designed in part to inform Medicare funding deliberations.

In their report the investigators characterized the observed 1.0‑ to 1.5‑point difference on the disability scale as clinically important, noting effects were comparable to or larger than those reported for some other pain treatments and were achieved with a low risk profile. They also observed signs of reduced anxiety and improved general pain ratings among patients who received acupuncture.

The study involved more than 50 licensed acupuncturists working within four major health systems in California, Washington, New York and Oregon. The authors said the results align with previous trials in mixed‑age populations and support acupuncture as a safe, accessible, nonpharmacological alternative for older adults with chronic lower back pain.