02/05/2026
Science Highlight: Cost effectiveness is added plus of acupuncture for back pain - by National Institutes of Health (NIH).
In a study that analyzed the cost of care provided to older adults being treated for low back pain, a research team funded by the National Institutes of Health (NIH) has found that acupuncture may provide cost-effective treatment compared to usual medical care. The team, led by researchers at the Kaiser Permanente Washington Health Research Institute in Seattle and health economists at RAND, followed 800 patients for one year as part of the BackInAction clinical study.
The team’s economic analysis is a companion to research published in September 2025 that found acupuncture needling to be safe and effective as treatment for older adults who have chronic or persistent low back pain.
Over one-third of older adults in the United States experience low back pain. Of the $134 billion spent annually on medical care for back and neck pain, over 30% of costs are incurred by those aged 65 and older, with the bulk paid by public insurance.
The study compared economic data for patient treatment across three large health care systems in California and Washington State. It compared results for participants in a group that received usual medical care, which included generally prescribed medications and other pain management services, with two groups of participants whose care included acupuncture.
The researchers assumed that an individual acupuncture visit cost about $90. Those in the standard acupuncture group received an average of 11 visits over the first three months and those in the enhanced acupuncture group received an average of16 visits over six months. At six and 12 months, chronic low back pain was significantly better for those who received acupuncture.
On average, the enhanced acupuncture group’s annual healthcare costs reduced by $491 per participant and those participants experienced significant quality-adjusted life-year gains. The group who received a standard course of acupuncture treatment had some increase in overall healthcare costs, but in an amount that would still be considered cost-effective given their quality-adjusted life-year gains. Both groups of participants who received acupuncture treatment incurred reduced non-acupuncture health care costs. The analysis suggests that their treatment with acupuncture may be cost-effective as compared with usual medical care for older adults with chronic low back pain in these three large health care systems in California and Washington State.
“Our findings suggest that enhanced acupuncture, and to a lesser extent standard acupuncture, may effectively address chronic low back pain in a manner that could be cost-effective for the health care sector and Medicare,” said lead author Patricia M. Herman, N.D., Ph.D., RAND Senior Behavioral Scientist. “Often complementary therapies such as acupuncture are only considered as additional treatment costs. Economic evaluations like this are essential to show when the addition of one of these therapies can reduce the need for other healthcare and be cost-effective or even cost saving.”
This work was supported by NIH’s Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, under award number UG3AT010739/UH3AT010739 administered by the National Center for Complementary and Integrative Health (NCCIH) with additional scientific support from the National Institute of Aging (NIA). The NIH HEAL Initiative seeks to speed scientific solutions to the overdose epidemic, including opioid and stimulant use disorders, and the crisis of chronic pain.
Reference: Herman PM, Mann S, DeBar LL, Avins AL, Justice M, Nielsen A, Pressman A, Stone KL, Wellman R, Cook AJ. Cost-Effectiveness of Acupuncture Needling for Older Adults With Chronic Low Back Pain. Spine (Phila Pa 1976). 2026 Feb 1;51(3):E65-E75. doi: 10.1097/BRS.0000000000005549. Epub 2025 Oct 29. PMID: 41493335.
Published February 1, 2026, in Spine
Level II.
