I'd like to see the best expert for acupuncture to treat my low back pain. I've already tried manipulation with a chiropractor. It didn't really seem to help that much. How do I figure out who the expert is? In our community, we have a board certified anesthesiologist who also does acupuncture and the chiropractor I've been seeing who has experience in acupuncture.

The definition of expert can be problematic. Is it based on skill and experience in one area? Or does it depend on the fact that the clinician is trained to do more than one modality?

Some experts define an expert as someone who can apply their particular brand of treatment with skill and get results. That brings up the question of what constitutes results. For some patients, pain relief is the intended result. For others, improved function means better quality of life and that's good enough.

It's difficult to know if the best, most reliable treatment comes with someone who has more years of experience or someone who has specialized in treatment using one specific treatment approach.

Combining treatments such as acupuncture and spinal manipulation may be more effective than either approach alone. But there simply aren't enough studies comparing one to the other to know for sure what works best.

In many cases, a clinician trained in more than one area will still depend more heavily on the area of treatment he or she feels most comfortable or most skilled in applying. It may not have to do with the patient's specific needs at all.