Suffering from back pain? The UK's National Health Service is now discouraging people with low back pain from seeking acupuncture due to the lack of sufficient evidence that it works.
The revised guidelines developed by the National Institute for Health and Care Excellence (NICE) on back pain and sciatica management no longer include acupuncture because its benefits are no different than a sham treatment or a placebo.
"[T]here is a lack of convincing evidence of effectiveness for some widely used treatments [like] acupuncture," said Professor Mark Baker, NICE clinical practice director.
An Australian study in early 2016 already debunked the benefits of acupuncture in treating menopausal symptoms like hot flushes.
NICE instead recommends a variety of combined physical and psychological approaches depending on the symptoms, clinical considerations, and preferences of patients.
The group also advocates exercises that emphasize the back, such as yoga and stretching, as the first line of treatment. They can then be complemented with massage and manipulation by a physiotherapist. The guidelines do not limit the activities of sufferers, but tell them to continue normal routines as much as they can.
When it comes to medications, non-steroidal anti-inflammatory drugs are the first choice. If the medication is not effective or the back pain is diagnosed as acute, weak opioids are provided. Paracetamol can no longer be taken alone.
Sufferers may also benefit from psychological treatments like "talking therapies" especially if they are facing social or mental issues that hinder or delay their recovery or when they have become less tolerant to pain. These may also work if the patient does not respond positively to medications and other forms of treatment.
The revised guideline, which is currently open for consultation until May 5 and meant for publication in September, is applicable to sufferers with low back pain and sciatica regardless of how long they have been diagnosed or when the condition has started.
The British Medical Acupuncture Society (BMAS) has already expressed its disappointment on the recommendation and believes the assessment of these studies has problems.
"It is partly to do with the decision to put the biggest emphasis on the difference over sham ... That is a problem for all physical therapies because physical therapy shams tend to be active - because you have to touch patients," said Dr. Mike Cummings, the BMAS medical director.
In the United States, where eight of 10 people are diagnosed with back pain, at least 3 million undergo acupuncture annually, according to the American Association of Acupuncture and Oriental Medicine.