NHS to give back pain acupuncture

[Alastair]

NHS to give back pain acupuncture
Lower back pain
Back pain is exceedingly common

Patients with persistent low back pain should be offered acupuncture, massages or exercises on the NHS, says guidance.

It is the first time the National Institute for Health and Clinical Excellence has explicitly backed the use of complementary therapies.

The rationing watchdog said evidence suggests they help and will be cost effective if doctors stop providing less proven back services like x-rays.

The move was welcomed by some charities and experts but criticised by others.


Patients whose pain is not improving should have access to a choice of different therapies including acupuncture, structured exercise and manual therapy
Professor Peter Littlejohns of NICE

Low back pain is a very common problem affecting one in three adults in the UK each year, with an estimated 2.5 million people seeking help from their GP.

For many people the pain goes away in days or weeks. But for some, the pain can persist for a long time and become debilitating.

NICE says anyone whose pain persists for more than six weeks and up to a year should be given a choice of several treatments, because the evidence about which works best is uncertain.

Complementary therapies

In addition to painkillers and regular advice to stay active and carry on with normal activities as much as possible, patients, together with their doctor, can decide to opt one of three complementary treatments.

This includes up to eight exercise sessions or 10 sessions of acupuncture over 12 weeks, or a course of manual therapy, which includes up to nine sessions of spinal manipulation, mobilisation or massage.


In my view, a critical risk benefit analysis of the most reliable data fails to come out in favour of chiropractic

Professor Edzard Ernst

Professor Peter Littlejohns, NICE Clinical and Public Health Director said NHS providers now had the opportunity to look at the services they provide and decide what changes are needed.

He said: "There is variation in current clinical practice, so this new NICE guideline means that for the first time we now have the means for a consistent national approach to managing low back pain.

"Importantly, patients whose pain is not improving should have access to a choice of different therapies including acupuncture, structured exercise and manual therapy."

Patients who fail to benefit from their first choice may be offered another of these options, he said.

If that doesn't work, they can try an intensive treatment programme combining exercise and psychological therapy.

Contentious

He said the costs to the NHS would be minimal - in the order of £77,000 - because they are offset by the savings in terms of reducing future disability and healthcare needs and moving away from treatments with little supportive evidence.

The guidelines, which apply to England and Wales, say doctors should no longer offer spinal x-rays or MRI scans or injections of therapeutic substances into the back for non-specific low back pain.

The Chartered Society of Physiotherapy welcomed the guidelines, as did Dr Dries Hettinga of the charity BackCare.

He said: "This offers a real choice for patients.

"This guideline will help patients understand what treatment and care can help them with their back pain and shows that there can be a positive outlook for treating this condition."

But others were critical of the recommendations.

Professor Edzard Ernst, an expert in complementary medicine at Peninsula Medical School, said he was surprised by the guidance and particularly by NICE's recommendation of spinal manipulation.

"It feels as though the panel was biased in favour of this approach thus over-rating its effectiveness and under-estimating its risks which can be considerable. In my view, a critical risk benefit analysis of the most reliable data fails to come out in favour of chiropractic.

"We must remember that no optimally effective treatment for back pain exists."

[katykat]

Alistair, I think NICE are just covering their backs. It is common knowledge that most back pain cases are muscular & I think that acupuncture may help in some cases, although it did nothing for me. However, these cases are most likely to be self limiting anyway & would usually get better within the 6 weeks qualifying period. Any longer than this & the cause is likely to be more than muscular & therefore less likely to respond to acupuncture. I do think though that it will be open to abuse.
Kath

[Alastair]

I think we must all agree that anything which widens our choice as back sufferers must be a help. I currently am undergoing a session of Chinese acupunture for something none spinal and its working well.

We all are different and if some proceedures work for us we should try them. I agree that where evidence of structural damage occurs then physio or surgery should be used - - - also I don`t think backing away from X-rays or MRI is helpful. It does sound like a "Money Saving" exercise, and we as a nation are short of radiographers and radiologists.

The information here is just what it says - -- -information -- -how you wish to use it is your affair

[alyssa.star]

I'm having acupuncture... privately though and my physiotherapist who's trained in it is doing it for me and it's working extremely well on my neck and shoulder area for my neck ache and headaches... but it doesn't seem to be effective at all on my lower back, probably because my pain is too bad and I'm far to tense. I'd recommend it to people though as I've had a good experience. Lyss

[csutton1]

How many people are going to suffer because they can not get an X Ray which will show any defects, untill the x ray is done it will always be classed as non spacific. I give Acupuncture and I always inform my clients that it is not an alternative to seeking medical help. it is a aid to compliment it.
I had Black box Acupuncture ( send a electric current via the pins) on friday which did not help the pain but Keith (husband) said I was moving better. I had hoped I would sleep better also but no luck there.
xxx