Back Pain With Acupuncture Treatment

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Back pain sufferers to be offered acupuncture treatment on the NHS

• Medical watchdog urges more alternative therapies
• Condition estimated to cost UK £5.1bn annually


Denis Campbell
The Guardian, Wednesday 27 May 2009
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Back pain sufferers will get improved access to treatments by acupuncturists, osteopaths and chiropractors on the NHS in an effort to reduce the misery, welfare bills and inability to work caused by the condition, it was announced today.

Advice issued by the National Institute for Clinical Excellence (Nice) recommends that the millions of people who develop persistent non-specific low back pain receive up to nine sessions of spinal manipulation or 10 sessions of ­acupuncture over 12 weeks.

Experts praised Nice's first guidance on how to tackle back pain as a breakthrough in treating a condition that costs the country an estimated £5.1bn every year, including £1bn of the NHS budget, and leads to the loss of around 5m working days. The problem affects around one in three adults each year and leads to 2.6 million people visiting their GP.

While most people with acute back pain recover within six weeks, an estimated 7% go on to develop a chronic form of the condition, which in the worst cases can lead to immobility and inability to work. Some GPs already offer acupuncture and some primary care trusts pay for patients to have manipulation privately. But Professor Martin Underwood, a Coventry GP who helped to draw up the advice, said current NHS treatment of back pain was "patchy".

In future sufferers in England and Wales will be given a choice of attending exercise classes, undergoing spinal manipulation or having acupuncture. Underwood said providing these treatments to patients in England and Wales may save the NHS money in the long term.

It will cost the NHS £24.4m to provide acupuncture and another £16m for ­manipulative therapy. But £33.6m will be saved by stopping the practice of injecting therapeutic substances into people's backs and £13.2m from reducing the number of sufferers sent for an MRI scan or X-ray.

Professor Steve Field, chairman of the Royal College of General Practitioners, welcomed the guidelines. "This is good news for GPs and patients. Most GPs deal with patients with backache every day of the week," he said. "I welcome the endorsement of some complementary therapies for which there is a clearer ­evidence base."

Dr Dries Hettinga, of the patients organisation BackCare, said: "These treatments are all effective. In future, virtually all ­people who get low back pain should be prevented from developing the serious form of the problem."

But it is unclear when patients will be able to routinely access the treatments on the NHS and if the NHS will pay for patients to visit private practitioners for treatment.

Laurence Kirk, head of osteopathy at Oxford Brookes University and osteopath to the Royal Shakespeare Company, said: "As osteopaths we knew that our treatment worked for most back pain sufferers, and it's good to have official recognition of that. This should mean that the public have greater access to the services of skilled manipulators who will alleviate pain."

But some opponents of alternative ­medicine criticised Nice. Edzard Ernst, professor of complementary ­medicine at Exeter University, said Nice had ­"overestimated the benefit and under-estimated the risks of chiropractic spinal manipulation".