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Acupuncture for non-specific low back pain
In the UK, the National Institute for Health and Clinical Excellence
(NICE) has recommended that acupuncture should be made available
on the NHS, as a cost-effective short-term treatment for the
management of early, persistent non-specific lower back pain.
Acupuncture stimulates the nerves in skin, muscle and other
tissues, and can produce a variety of effects. We know that
it increases the release of the body’s natural painkillers,
including endorphin and serotonin, in the pathways of both the
spinal cord and the brain. This modifies the way pain signals
are received by the brain.
The NICE guidelines for low back pain cover the early treatment
and management of persistent or recurrent low back pain, defined
as non-specific low back pain that has lasted for more than
6 weeks, but for less than 12 months.
Non-specific low back pain here is defined as, “tension, soreness
and/or stiffness in the lower back region for which it isn’t
possible to identify a specific cause of the pain”.
The guidelines suggest a pathway to
- Offer drug treatments as appropriate
- Offer one of the following treatment options taking patient
preference into account: an exercise programme a course of
manual therapy, a course of acupuncture comprising up to a
maximum of 10 sessions over a period of up to 12 weeks.
In order to come to the conclusion to include acupuncture in
this pathway, NICE felt the strongest evidence came from the
following study:
Thomas, K. J., MacPherson, H., Ratcliffe, J. et al (2005) Longer
term clinical and economic benefits of offering acupuncture
care to patients with chronic low back pain. Health Technology
Assessment 9, 32
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