Since 2009, the use of acupuncture has beenrecommended as a treatment for chronic back pain by the U.K.s National Health Service (NHS). But after a review of the scientific evidence for whether the procedure provides pain relief, the National Institute for Health and Care Excellence (NICE), which draws up guidelines for patient care for the NHS, has concluded that the treatment is no better than a placebo in treating those suffering from sciatica and lower back pain, and should stop being used.
Regrettably, there is a lack of convincing evidence of effectiveness for some widely used treatments, says Professor Mark Baker, clinical practice director forNICE, in response to the new report. 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. In other words, acupuncture is no better than a mock procedure that mimics the therapy.
The draft guidelines come after the authors compared multiple studies looking into the effectiveness of acupuncture in clinical trials, both as an addition to other treatment as well as a procedure on its own. They found that while in many cases it might appear to be providing benefit and pain relief to patients, it was in fact no different to the placebos. They also found that paracetamol on its own was not effective either. Instead, the draft guidelines recommend regular exercise in all its forms as the first attempt to treat low back pain, and if drugs are to be used, try non-steroidal anti-inflammatory drugs such as ibuprofen first.
The evidence suggests that it is more the environment and context that helps the patients, rather than the acupuncture treatment itself. So, the evidence showed that there was no clinically important difference between acupuncture and sham acupuncture for its effects on pain, explains Dr. Ian Bernstein, a GP and musculoskeletal physician based in London. The guidelines development group thought that acupuncture was unlikely to have a specific biological treatment effect, but was acting through contextual mechanisms such as seeing a caring and pathic health care professional, or the laying on of hands.
The review of evidence for acupuncture comes following another debate surrounding the prescription of homeopathy by the NHS. This has been met with great criticism from many researchers and scientists, who suggest that the NHS has a duty to ensure its funds are spent on the most effective treatments, and that homeopathy is not one. Last year, the government announced a review into whether or not the taxpayer should be funding these treatments.