NICE Guidelines Dismiss Acupuncture as Effective Treatment for Low Back Pain

Tuesday, 29th March 2016

Acupuncture is no longer recommended as a treatment for low back pain on the NHS, according to new draft guidelines released this week by the National Institute for Health and Care Excellence (Nice).

The u-turn comes after a review of scientific evidence found that the practice was no better than a placebo in treating those living with low back pain and sciatica.

The draft guidelines report that there have now been a large number of scientific trials looking into the effectiveness of acupuncture but that, “there was still not compelling and consistent evidence of a treatment-specific effect for acupuncture.”

Low back pain is thought affect one in 10 people, while its cost to the UK economy is estimated to exceed £12 billion a year in lost productivity.

Nice guidelines from 2009 on the early management of low back pain recommended that healthcare providers “consider offering a course of acupuncture needling comprising up to a maximum of 10 sessions over a period of up to 12 weeks.”

But the new draft guidelines, now covering sciatica as well as low back pain, contain an unequivocal message stating: “Do not offer acupuncture for managing non-specific low back pain with or without sciatica.”

Professor Mark Baker, clinical practice director for Nice, said: “Regrettably, there is a lack of convincing evidence of effectiveness for some widely used treatments. For example, acupuncture is no longer recommended for managing low back pain with or without sciatica. This is because there is not enough evidence to show that it is more effective than sham treatment.”

The draft guidelines also reveal that paracetamol is no longer recommended as “the first medical option” and should not be used on its own. Instead, they advise that non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen should be considered. Codeine and other weak opioids are only recommended in acute cases and only if other anti-inflammatories cannot be taken or if they are not found to help.

The Nice guidelines are open for consultation until 5 May, the final version of the guidelines is expected to be published in September.