News & Views
NICE recommends acupuncture for back pain
The National Institute for Health and Clinical Excellence has recommended acupuncture for back pain.
NICE, the independent body that advises doctors on best clinical practice, has released new (evidence based) guidelines for the management of persistent, non-specific low back pain. The guidelines recommend acupuncture, physical exerise or manual therapy as first line treatments for those with back pain that has lasted more than six weeks.
The use of steroid injections for the condition is discouraged. Instead, acupuncture is recommended as the most effective invasive procedure. The guidelines recommend that doctors should consider advising a course of acupuncture treatment comprising up to a maximum of 10 sessions over a period of up to 12 weeks.
A fun article
Of course the back pain announcement was picked up by the media in numerous ways. One of the most entertaining was an article in the Daily Express about fashion designer Scott Henshall's experience of acupuncture for back pain. You can view the article in full on: http://www.express.co.uk/posts/view/158494/I-m-scared-of-needles-but-acupuncture-works You dont have to be scared of needles for acupuncture to work! Evereyone feels them differently, and many people feel them very little. Any sensation will be brief, and most people find acupuncture relaxing. Some even fall asleep on the couch!
How safe is acupuncture?
In 2001 the British Medical Journal published research that points to acupuncture being "safe in the hands of competent practitioners."
While this is not news, it may be new information to many readers.
The researchers conducted a practitioner survey of members of the British Acupuncture Council. A total of 574 practitioners reported on patient reactions to 34,407 acupuncture treatments. (1)
Mild transient reactions
These were reported to have taken place during or after 5136 treatments. In all 10920 reactions occurred in 15% of the treatments. This suggests that these are quite common experiences for acupuncture patients. They were:
- Feeling relaxed in 12% of treatments
- Feeling energised in 6.6% of cases
- Tiredness in 2.6% of cases
- Drowsiness – 1.1% of treatments
- Dizziness, nausea or feeling faint occurred in a total of 1.1% of cases
Aggravations to existing symptoms occurred in 2.8% of cases. Of these, all but 0.4% were followed by an improvement. This fits the picture of the classical "healing reaction", which is common to many therapies.
There were some local reactions at the site of needling: local pain in 1.2%; bruising in 1.7%; and minor bleeding in 0.4% of treatments.
Minor adverse events
Only 43 were reported. These included nausea, dizziness, pain, bruising and aggravation of symptoms with no resulting improvement, totalling a rate of 0.09-0.17%. Therefore 34364 treatments were given with no adverse effects at all
Serious adverse events
These were classified as hospital admission, permanent disablement or death. None were reported.
What this tells us
This survey followed another published in the same journal, of acupuncture given by doctors and physiotherapists. (2) Both surveyed a similar number of treatments and had considerable similarities of results. The results were what I expected. In my experience a significant number of patients experience feeling relaxed, tired or energised after acupuncture. A tiny minority feel briefly faint or dizzy, and minor bruising or mild bleeding occurs in a small number of sessions. All this suggests that acupuncture, administered correctly by fully trained professional practitioners, is a very safe treatment.
(1) Macpherson et al. BMJ 2001;323;486-487
(2) White et al. BMJ2001;323:485-486