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Medicare may cover acupuncture for lower back pain

Written by Diane Archer

The Washington Post reports that, under a new proposal, the Centers for Medicare and Medicaid Services (CMS) would permit Medicare to cover acupuncture for lower back pain in limited situations. Until now, Medicare has not deemed acupuncture a covered service for treatment of any condition.

Lower back pain is a common condition impairing the quality of life for millions of Americans. And, it can lead to disability. The cost of treating chronic pain in the US is several hundred billion dollars each year. What causes back pain? A number of factors, including genetics, psychological, and environmental. Consequently, determining how to manage it can be difficult.

Acupuncture has been a source of healing in Asia for thousands of years. But, the evidence is not clear that acupuncture can help lower back pain. Acupuncture may only be a placebo, a treatment that offers no therapeutic effect; though, placebos can offer a psychological benefit.

The CMS proposal would offer acupuncture to patients with lower back pain in clinical trials funded by the National Institutes of Health.

The American College of Physicians supports testing alternatives to prescription drugs, particularly opioids, for lower back pain. These alternatives include yoga, exercise and acupuncture.

The Agency for Healthcare Research and Quality found that people with lower back pain who receive acupuncture may see some improvements in function and feel less pain in the short term.  However, AHRQ did not find long-term improvements in function or pain.

A meta-analysis in the Pain Practice journal found that, for short-term outcomes, acupuncture showed significant improvement over a placebo for back pain. Over the long term, however, acupuncture outcomes were inconsistent. The study did not determine whether the overall benefit of acupuncture is meaningful and cost-effective.

For back pain, Medicare covers some drugs, as well as injections, braces and chiropractic care. In some cases, it covers implanted neurostimulators.

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