“The criteria that NICE used to evaluate acupuncture for low back pain are not the same as those used for other physical therapies, and therefore the recommendations are founded on evidence biased medicine rather than on evidence based medicine.” Professor Hugh MacPherson of the University of York

Today the UK’s National Institute for Health and Care Excellence (NICE) published an update to its guidelines for the management and treatment of low back pain and sciatica that removes acupuncture as a recommended treatment – despite the fact that evidence shows it has one of the best combinations of benefit to harm ratio of any treatment evaluated by NICE.

This decision reverses the recommendations of the 2009 committee, who recommended it on the basis of robust evidence. Removing the recommendation for acupuncture means GPs will need to rely more on treatments such as painkillers (which are less safe than acupuncture – 2000 preventable deaths a year in the UK) and exercise (which is less effective).

The reversal by this committee stands in contrast to recommendations by research and policy institutions in countries such as the United States, Canada, Germany and Australia.  These increasingly include acupuncture as a safe, effective, non-pharmacological treatment for low back pain based on evidence that shows acupuncture outperforms usual care, and has fewer risks and side effects than commonly used pain medications.

The updated recommendations will mean reduced choice for patients and their health care providers as they could lose access to acupuncture on the NHS when it has one of the best combinations of benefit to harm ratio of any treatment evaluated by NICE, leaving providers with less effective options that potentially carry a greater risk.”