I'm thinking about trying acupuncture for my low back pain. Are there side effects I should be warned about?

Q: I'm thinking about trying acupuncture for my low back pain. I've tried everything else and I don't want to take pain meds any more. I think I can handle the pokey needle part but are there other side effects I should be warned about?

A: Acupuncture as an alternative treatment to traditional medicine has been making the news. More and more studies are showing its positive effects on chronic low back pain. But differences in how the studies are conducted have left some lingering doubts as to the true benefit of this treatment. Since patients receiving a placebo treatment seem to fare as well as those receiving the "true" acupuncture treatment, further study is needed.

In the meantime, what has been shown so far has been very promising. One of the valuable "side effects" or benefits of acupuncture is both a reduction in the severity of pain as well as how "bothersome" that pain is for each patient. When pain is reduced, function and ability increase -- two additional side effects, if you will.

But you are really asking more about the adverse effects -- what some might refer to as the negative effects of acupuncture. Most adverse effects reported are mild and temporary. Some patients say their back pain increases at first and then subsides. Some people do not tolerate the local pain from the needle insertion. There is the possibility of bruising where the needle goes into the skin if a tiny vein is punctured.

Because acupuncture needles are inserted along lines of energy called meridians, it is possible to experience pain somewhere else along that meridian. So acupuncture for low back pain may result in pain in the shoulder or foot. Sometimes patients report feeling sluggish or having overall body aches in the first 24 to 48 hours after the acupuncture treatment. But all of these potential side effects go away in time. And often the person feels much better than before the treatment.

When you meet with your intended acupuncturist, you can certainly ask this question and see what his or her experience has been. There is also some evidence from studies that patients having a positive expectation of the treatment benefit improvement in painful symptoms. This occurs in cases where "sham" acupuncture is delivered. Sham acupuncture refers to nonpenetrating acupuncture. A blunt-tipped needle is used to make contact with the skin but without piercing through the skin.

Reference: Yu-Jeong Cho, KMD, PhD, et al. Acupuncture for Low Back Pain. In Spine. April 1, 2013. Vol. 38. No. 7. Pp. 549-557.