context: Nearly 8 out of every 10 people will have low back pain at some point in life. Back pain is one of the top reasons people seek medical treatment. It is also the No. 1 reported reason for seeking acupuncture. The good news is chronic low back pain is one of the conditions that research suggests acupuncture may be an effective tool for treating. One recent review of 22 acupuncture studies showed that it provided short-term relief from chronic back pain. It also showed there was greater improvement in pain for people who got acupuncture compared to those who received a âshamâ treatment. Other studies have found, though, that sham acupuncture can be as effective as actual acupuncture. Those studies also found that, compared to standard treatment, both actual acupuncture and sham acupuncture are more effective. Guidelines from the American Pain Society and American College of Physicians say doctors should consider acupuncture as an alternative therapy for patients with chronic low-back pain that's not helped by conventional treatment. Acupuncture began in China more than 2,500 years ago. It involves inserting thin needles at certain points on the body. According to traditional Chinese medicine, the body has more than 2,000 of these points. They are connected by pathways or meridians, which create a flow of energy called Qi (pronounced âcheeâ). Stimulating these points is said to correct the imbalance of qi and improve the flow of energy. Practitioners believe that this helps relieve pain and improve health. It's thought the effects come from stimulating the central nervous system. This may trigger the release of chemicals into the muscles, spinal cord, and brain. These chemicals either alter the experience of pain or produce bodily changes that promote a sense of well-being. Other theories suggest acupuncture works by: Speeding the relay of electromagnetic signals. This may begin the flow of pain-killing chemicals such as endorphins. Or it may release immune system cells in the body. Triggering the release of natural opioids. These are chemicals in the brain that may lessen pain or promote sleep. Changing brain chemistry by altering the release of neurotransmitters and neurohormones. Neurotransmitters either stimulate or dampen nerve impulses. Neurohormones can affect the function or activity of an organ in the body. When done by an experienced, trained acupuncturist, the procedure is generally safe. Serious side effects, such as infections or punctured organs, are rare. Also, acupuncture has fewer adverse side effects than many of the standard treatments for back pain. If other treatments have failed and you are considering acupuncture, discuss it with your doctor. Be sure to let your doctor know any other medications you are taking. Also tell your doctor if you are pregnant, wear a pacemaker, or have any type of implant. Your doctor may be able to refer you to a licensed acupuncturist. You may also contact the American Academy of Medical Acupuncture for the name of a doctor who does acupuncture. Before starting acupuncture, find out if your health insurance will pay for it. Also ask how many treatments you should expect and how much they will cost.