Brain Imaging Study of Acupuncture in Chronic Low Back Pain

We are doing this research study to learn about how acupuncture treatment works. This study is being done to look at changes in the brain, NOT to treat pain. We want to learn about brain activity during acupuncture. We will look at brain activity when a heating device touches the skin of a subject before and after the subject has acupuncture, to see what changes.

• Low Back Pain
• Back Pain Lower Back Chronic
• Low Back Pain, Recurrent

• Experimental: Traditional Acupuncture
  Traditional Acupuncture given at 2 visits.
  Intervention: Procedure: Acupuncture
• Experimental: Electroacupuncture
  Electro-acupuncture given at 2 visits.
  Intervention: Procedure: Acupuncture

Inclusion Criteria:

• Meet the Classification Criteria of chronic LBP (having low back pain for more than 6 months), as determined by the referring physician
• At least 4/10 clinical pain on the 10-point LBP intensity scale on average during the past two weeks prior to enrollment
• At least a 10th grade English-reading level; English can be a second language provided that the patients feel they understand all the questions used in the assessment measures
• Must have had a prior evaluation of their low back pain by a health care provider, which may include radiographic studies. Documentation of this evaluation will be obtained from the subject's medical record

Exclusion Criteria:

• Specific causes of back pain (e.g., cancer, fractures, spinal stenosis, infections)
• Radicular pain extending below the knee
• Complicated back problems (e.g., prior back surgery, medicolegal issues)
• Possible contraindications for acupuncture (e.g., coagulation disorders, cardiac pacemakers, pregnancy, seizure disorder), and conditions that might confound treatment effects or interpretation of results (e.g., severe fibromyalgia, rheumatoid arthritis)
• Conditions making study participation difficult (e.g., paralysis, psychoses, or other severe psychological problems as per the judgment of a study investigator and/or a T score > 60 on the psychological measures assessed during Session 1)
• Prior acupuncture treatment for any condition. Because we are using a placebo needle as a control, acupuncture-naive patients are necessary to maximize the benefits of blinding and to control expectancy.
• Active substance abuse disorder in the past two years, as determined by subject self-report
• The intent to undergo surgery during the time of involvement in the study
• History of cardiac, respiratory, or nervous system disease that, in the investigator's judgment, precludes participation in the study because of a heightened potential for adverse outcome. For example: asthma or claustrophobia
• Presence of any contraindications to MRI scanning. For example: cardiac pacemaker, metal implants, fear of closed spaces, pregnancy
• Unresolved legal/disability/workers compensation claims in connection with low back.
• Instability of pain ratings in Session 2 or Session 3
• Use of prescription opioids or steroids for pain

• Massachusetts General Hospital
• National Center for Complementary and Alternative Medicine (NCCAM)