You lifted too much, overdid it on the tennis court, sat slouched too long at the office desk. Bed rest and painkillers, you've tried. If you still don't have relief, maybe it's time you saw a doctor.

Second to the common cold, low back pain actually is the most frequent reason people see a doctor or miss work. The U.S. Department of Health and Human Services estimates Americans pay $50 billion a year in the United States.

Most back pain disappears on its own in seven to 10 days. But whether the pain lasts a short while or is chronic, you'll want to find out if it's something serious and you'll want relief.

What is medical acupuncture?

As alternative medicine increases in popularity, more patients are finding relief through medical acupuncture, a centuries-old Chinese healing technique practiced by licensed doctors. A medical acupuncturist can prescribe medications, order diagnostic testing and give acupuncture to alleviate the pain of acute or chronic back pain, according to Robert Schulman, M.D., a physical medicine/rehabilitation specialist in New York City, and member of the board of the American Academy of Medical Acupuncture.

"A medical acupuncturist is truly giving you the best of both worlds," Schulman says.

Most low back pain, whether acute or chronic, almost always can be treated without surgery. And modern medical wisdom holds that no one treatment is a miracle cure. Relief, experts say, is best obtained through a variety of ways. Drugs can control pain and discomfort, although medication might have side effects. Exercise, physical therapy, spinal manipulation or osteopathic manipulative therapy and chiropractic treatment can also help.

"As a stand alone treatment, there are gaps in what acupuncture does," Schulman says. However, acupuncture used synergistically with other treatment often can speed the healing process, he says.

How does it work?

Several theories exist about why acupuncture works. From the Chinese perspective, back pain is an obstruction of "chi," or the body's own internal energy. Acupuncture regulates the flow of chi, so chi stagnation doesn't cause pain, Schulman explains.

From a more Western perspective, the tiny acupuncture needles, which are placed at different points in the body, stimulate the production of endorphins, "the body's own natural analgesic," Schulman says.

Putting an acupuncture needle into a muscle that's contracted helps coax that muscle to relax. Another theory about how acupuncture works for back pain is that it stimulates nerves in the legs and thighs, and decreases inflammation of the nerves in the lower back that are causing pain.

What's more, the acupuncture treatment itself is profoundly relaxing, particularly if stress or tension perpetuates your back pain, Schulman says.

Acupuncture can be effective in treating acute or sudden pain and chronic pain, although it often takes longer to treat chronic pain, according to Schulman. With chronic pain, he says it typically takes an average of 10 to 15 treatments during eight to 15 weeks. That is, once or twice a week over that time period.

"If you have had back pain for five to 10 years, it's going to take some doing to get better," Schulman says. "We also assume you're going to use any and all methods at the same time. You still may need to be in a good therapy program, and you still might use medication. But the goal with acupuncture is to get you off medication more quickly."

Acupuncture needles are sterile, disposable and thinner than a pin. The procedure is safe and painless if done properly, Schulman says. According to the Food and Drug Administration, few complications have been reported with acupuncture, considering the millions of people treated each year and the number of needles used.

In acupuncture for back pain, the needles sometimes are put into the ankles or behind the knee, or alongside your little finger. In a similar technique, called percutaneous electrical stimulation (PENS), acupuncture needles are used but specific acupuncture points are not.

"In the PENS technique, needles are put in sites that correspond with relevant neurological intervention," Schulman explains. "That is, the region of the nerve roots that enervate the muscles, bones and tendons of the region that is in pain."

For insurance purposes, PENS still counts as acupuncture, Schulman advises.

Documenting acupuncture's success

According to a National Institutes of Health panel of scientists, researchers and practitioners, clinical studies have shown that acupuncture works as a therapy for back pain and other conditions, including, to name a few, osteoarthritis, carpal tunnel syndrome and stroke rehabilitation.

Schulman says there have been problems doing double-blind placebo clinical studies -- a gold standard for medical research. It's difficult to provide a placebo because "most people know if they are getting acupuncture," he says. Furthermore, it's difficult to have a double-blind test because it's impossible to 'blind' the person doing the acupuncture. "They know whether they're doing it or not."

However, Schulman says, "There are 2,000 years of history with acupuncture; and we don't have that 2,000 years of history with some (modern) medical procedures we do."

To find a medical doctor who practices acupuncture in your area, call the American Academy of Medical Acupuncture at 1-800-521-2262.

You can check whether a practitioner is licensed or registered and has attended an accredited school of acupuncture by using the referral list developed by the American Association of Acupuncture and Oriental Medicine.

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External Sources American Association of Acupuncture and Oriental Medicine U.S. Department of Health and Human Services National Institutes of Health

This article was reviewed and updated June 2007.