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The publication of a new guideline for chronic pain treatment by the National Institute for Health and Care Excellence (NICE) is a major advance for the recognition of acupuncture as a legitimate clinically effective treatment in the UK. This is the first time that NICE has released a guideline specifically focused on chronic primary pain where there is no underlying condition that adequately accounts for the pain or its impact. Around a third of the UK population reports suffering from a chronic pain condition, often accompanied by significant emotional distress, functional disability and absence from work. Common conditions that fall into this category include fibromyalgia, myofascial pain, and chronic neck, back and pelvic pain. In a significant change to their pain treatment policy, NICE no longer endorses the use of painkillers, instead directing doctors to offer patients with primary chronic pain one of four recommended treatments: exercise, talk therapy, acupuncture and antidepressants. A single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system, is recommended as long as it is delivered in a community setting by a healthcare professional with appropriate training and takes up no more than five hours of healthcare professional time, or is delivered in another setting for an equivalent or lower cost. The NICE committee that developed the guideline acknowledged that there was a large evidence base showing acupuncture to be clinically effective in the short term, citing 27 studies showing that it reduced pain and improved quality of life for up to three months. The Royal College of General Practitioners backed the shift away from painkillers but cautioned that patients’ access to the new forms of treatment being recommended was currently variable. A press release from the British Acupuncture Council (BAcC) welcomed the new guideline as ‘a significant development for both patients with chronic pain and acupuncture practitioners in the UK’.

Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline [NG193].