Here we take a look at why NICE recommends acupuncture, and summarise the evidence for its use.
Did you know that in the UK NICE (National Institute for Health and Care Excellence) recommends Acupuncture for the treatment of migraines, headaches and back pain on the NHS. Some GP practices offer integrated healthcare that includes acupuncture, but this is not yet commonplace. As an alternative, many people choose to go pay for acupuncture privately.
With over 3,000 members the British Acupuncture Council (BAcC) is the UK’s largest regulatory body for practitioners of traditional acupuncture. The BAcC is a founder member of the Professional Standards Accredited Voluntary Register (AVR) and maintains high standards of training, safe practice and professional conduct.
Many company health insurance schemes will cover treatment provided by British Acupuncture Council members – we suggest you read the small print.
The following is a brief review of available evidence for the treatment of three common conditions with acupuncture.
Back pain can affect anyone at any age and most people will suffer from it at some point in their lives. It is the UK’s leading cause of disability and one of the main reasons for work-related sickness absence.
According to the Acupuncture Research Resource Centre, ‘research has shown that acupuncture is significantly better than no treatment and at least as good as (if not better than) standard medical care for back pain. It appears to be particularly useful as an adjunct to conventional care, for patients with more severe symptoms and for those wishing to avoid analgesic drugs’.
NICE clinical guideline 88 makes recommendations for the early management of persistent non-specific low back pain (ie pain that has lasted for more than 6 weeks, but for less than 12 months). Their recommendation is for up to 10 sessions of acupuncture over 12 weeks.
In addition to needle therapy, it is common for traditional acupuncturists to use cupping, moxa therapy (i.e. warming), auriculotherapy, adjunctive electrostimulation, dietary advice, massage and exercises according to the patient’s individual characteristics.
Migraine is a primary headache disorder manifesting as recurring attacks, usually lasting for 4 to 72 hours and involving pain of moderate to severe intensity (IHS 2004).
According to the Acupuncture Research Resource Centre, ‘research has shown that there have now been many controlled trials of acupuncture for migraine, with some large, high-quality ones in recent years. The results of the latest reviews are quite consistent: acupuncture is significantly better than no treatment/basic care for managing migraine, and appears to be at least as effective as prophylactic drug therapy, with few contraindications or unpleasant side effects’.
According to the NICE clinical summary on migraines in adults, ‘evidence suggests that the addition of acupuncture to treatment of acute migraine attacks or to routine care is beneficial for at least 3 months, and that acupuncture is better than evidence-based prophylactic drug treatment’.
They recommend the use of acupuncture for up to 10 sessions over a course of 5 to 8 weeks as second-line prophylactic treatment. They also found that when 10 sessions are provided, acupuncture is more cost-effective to the NHS than no treatment.
Tension-type headache is the term used for infrequent and frequent episodic, as well as chronic, tension-type headaches. They occur in up to around 80% of the UK adult population, and are more prevalent in women.
The Acupuncture Research Resource Centre states that ‘evidence from the most up-to-date and highest quality systematic review showed that there are clinically relevant benefits of adding acupuncture to routine care and also a statistical advantage of ‘true’ acupuncture over sham interventions’.
Although they go on to assert that current evidence is as yet insufficient to strongly support the use of acupuncture for treating tension-type headaches, NICE state that ‘because they found very little evidence to support the use of pharmacological prophylaxis, this evidence was sufficient to recommend its use’. Hence ‘a course of up to 10 sessions of acupuncture over 5–8 weeks is recommended.