A study funded by the National Institutes of Health revealed acupuncture needling provided greater improvements in back pain–related disability at six months and 12 months compared with traditional medical care alone. Photo by Ryutaro Tsukata/Pexels
A new study demonstrating the effectiveness of acupuncture in relieving chronic lower back pain among seniors is fueling calls to expand Medicare coverage for the procedures amid the continuing struggle to reduce opioid abuse.
In a large-scale, randomized study published Friday in JAMA Open Network, researchers from the Kaiser Permanente Center for Health Research and elsewhere found that acupuncture needling yielded greater improvements in back pain-related disability at six months and 12 months than traditional medical care alone.
The National Institutes of Health-funded “Backinaction” clinical trial demonstrated that acupuncture needling is an effective and safe treatment option offering “modest” but noticeable and long-lasting relief for older adults with chronic lower back pain — the leading cause of disability worldwide, affecting one-third of all U.S. adults over age 65, the study’s authors said.
Chronic back pain has been identified as one of the key drivers of the opioid addiction and overdose crises, which took hold between 1999 and 2010 as U.S. opioid sales quadrupled. By 2015, more than half of regular opioid users reported they suffered from back pain and took the drugs despite their limited effectiveness against back pain.
Even though the number of drug overdose deaths have been dropping since 2021, opioid-related fatalities still account for tens of thousands of deaths annually, according to the National Institute on Drug Abuse. Nearly 9 million Americans misused opioids in 2024, while almost 20 million lived daily with chronic pain that interferes with their lives.
In the study, 800 older adults with chronic lower back pain were divided into three groups: those who received standard acupuncture treatments of eight to 15 sessions over 12 weeks in addition to their usual medical care; another group getting the same care plus up to six additional maintenance sessions over 12 additional weeks; and a group receiving only their usual care, with no acupuncture.
At both the six-month and 12-month points, the groups receiving acupuncture treatments reported greater reductions in pain disability than those who received usual medical care alone. The intensity of their pain decreased and they also enjoyed greater physical function compared to the non-acupuncture group, the authors reported.
The Backinaction study was undertaken as part of the NIH’s Helping to End Addiction Long-term, or HEAL, Initiative, which seeks to speed scientific solutions to stem the opioid crisis.
“Of the different treatments we have for chronic low back pain, most have a somewhat modest effect. They often reduce pain by about a third at best and can help people function better,” lead author Lynn DeBar, the Kaiser Permanente distinguished investigator, said in a statement.
“Our clinical results suggests that acupuncture is working as well as many things that are more familiar to people. We found that the size of this effect, while modest, was positive and sustained.”
The results come five years after Medicare agreed to begin covering limited numbers of acupuncture treatments for lower back pain, but only when administered or supervised by a physician or other qualified provider in a hospital or clinic setting.
Under current law, state-licensed, independent, community-based acupuncturists, who comprise the vast majority of providers, are not considered qualified and thus cannot bill Medicare directly for their services. Backers of proposed federal legislation to change that told UPI they hope the Backinaction study will boost support for the the Acupuncture for Our Seniors Act, under which independent acupuncturists would be deemed qualified for Medicare reimbursement.
The bill, first introduced in 2023, is an amendment to Title XVIII of the Social Security Act ensuring that licensed acupuncturists can participate as providers in Medicare “so that seniors have this effective treatment option available to them.”
Amy Mager, vice chair of public policy for the American Society of Acupuncturists, said the Backinaction study confirms earlier research demonstrating the efficacy of acupuncture in relieving back pain and strengthens the case for the federal legislation.
“This study shows that achieving back pain relief from acupuncture is verifiable and replicable, and that treatments can make a huge differences in people’s lives at a year out,” she told UPI in an interview.
Mager, a doctor of acupuncture and Chinese medicine and practicing licensed acupuncturist in Northampton, Mass., noted the study was run by licensed acupuncturists, who are the “best qualified” to administer the procedures and possess the skills to help ease the chronic suffering of patients.
“Only 15% of our providers currently work in hospitals, which means there are a lot of the 33 million Medicare recipients in the United States who cannot get access to this care from experts in the field. We’re hoping to change that.
“The goal would be that when we look at healthcare as a right and not a privilege, we can make sure that all of our elders can access this care for chronic low back pain.”
Seniors who use community based acupuncturists cannot submit Medicare “1490S” forms requesting reimbursement, and thus have to shoulder all of the costs, Mager said.
But under the Acupuncture For Our Seniors Act, they would be able to bill Medicare, “and that would mean we could serve as many people as possible who want these services from trained and vetted professionals.”
Another acupuncture expert and clinical researcher told UPI the Backinaction study indeed confirms long-held beliefs in acupuncture’s efficacy in treating chronic pain.
Dr. Gary Deng, director of integrative oncology for UCI Health’s Chao Family Comprehensive Cancer Center and Susan Samueli Integrative Health Institute in Irvine, Calif., said the results did not surprise him given his own extensive studies documenting how acupuncture can help patients dealing with cancer pain.
“Investigators, myself included, have conducted many acupuncture clinical trials over the years. It is quite established from those studies that acupuncture helps reduce pain,” he said.
“What makes this study important and significant is its scientific rigor. It is a large randomized controlled trial of 800 people, meaning that we can have more confidence in the results, conducted at multiple study sites. Therefore, the results are generalized to apply to real-world situations.
“What did surprise me was that the effects lasted up to 12 months after only three months of, on average, once weekly treatment,” Deng added. “If you take a pain pill for chronic pain, the effects will stop once you stop taking the pills. Not so for acupuncture, according to this study.
“Taking pain medications for chronic pain is not a good long-term solution because the drugs have side effects. Acupuncture is another tool in our toolbox to address this condition.”
