Podcast 1008: Acupuncture for Low Back Pain in Older Adults

Contributor: Aaron Lessen, MD

Educational Pearls:

• Back pain is a common presenting complaint in the emergency department.

• Challenges arise when tailoring care to elderly populations using standard medical therapy:

• Muscle relaxants carry the risk of CNS depression or anticholinergic effects such as urinary retention and confusion.

• Pain medications such as opiates have side effects including constipation, respiratory depression, and hypotension.

• NSAIDs carry a risk of GI bleeding and worsening kidney function with chronic use.

• A randomized clinical trial assessing the effects of acupuncture on low back pain took 800 adults aged 65 and older with chronic low back pain and placed them into one of three treatment arms:

• Usual medical care

• Standard acupuncture consisting of 8–15 treatment sessions over 12 weeks, plus usual medical care

• Standard acupuncture consisting of 8–15 treatment sessions over 12 weeks, plus 4-6 maintenance sessions during the next 12 weeks, plus usual medical care

• Using the Roland-Morris Disability Questionnaire (RMDQ) score, they assessed disability at 6 months and 12 months.

• The study found that those who had undergone treatment with acupuncture had significantly greater improvements in disability related to low back pain compared to the group that was only treated with usual medical care.

• Acupuncture is not used in the ER, but could represent a relatively safe adjunctive therapy for patients who are not responding to standard medical therapy alone.

References:

1. American College of Surgeons Committee on Trauma. Best practices guidelines: geriatric trauma management. American College of Surgeons; 2023. Accessed May 27, 2026. https://www.facs.org/media/ubyj2ubl/best-practices-guidelines-geriatric-trauma.pdf

2. DeBar LL, Wellman RD, Justice M, et al. Acupuncture for chronic low back pain in older adults: a randomized clinical trial. JAMA Netw Open. 2025;8(9):e2531348. doi:10.1001/jamanetworkopen.2025.31348

Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Ahmed Abdel-Hafiz, NREMT-P