Tag Archives: Pain Management

Question Marks

Will acupuncture help me?

Many people ask us as acupuncturists: “What is acupuncture for?  Will it help me?”

There is not a specific list of conditions acupuncture can “treat”, but it can be used safely by the vast majority of patient groups, including during pregnancy, as there are very few contraindications. 

Our Condition Resources Pages provide links to evidence-based factsheets, based on the most commonly requested reasons for attending acupuncture.

A huge number of clinical guidelines now recommend/suggest acupuncture as an approach; most commonly for musculoskeletal, connective tissue, neurological, obstetrics & gynaecology, women’s health, oncology and gastrointestinal issues. (Zhang & al 2022a)

Acupuncture needles in a patient’s back

It is good to read around the research into the symptom or condition you’re looking to address, the factsheets, links and references here on our condition pages are a good place to start, enabling you to find and appraise the original research papers.

Pain

Acupuncture is well-known for use in pain, and is recommended in many countries’ national health services. The NHS body in charge of which treatments should be used in particular conditions recommends acupuncture for chronic pain:  The NICE Scenario Management guidelines (2021) for chronic pain state: “consider a course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system”. In America, per the US government’s National Institutes of Health: “Clinical practice guidelines issued by the American Pain Society and the American College of Physicians in 2007 recommend acupuncture as one of several nondrug approaches physicians should consider when patients with chronic low-back pain do not respond to self-care (practices that people can do by themselves, such as remaining active, applying heat, and taking pain-relieving medications).”

Popularity with the public, and uptake by insurers

Acupuncture is popular and well established. Per the WHO (2019) global report, acupuncture is widely used across the world, and in the UK, clinicians administer over 4 million acupuncture treatments each year (Zhang et al, 2022b).

Per He et al (2022) in the BMJ “Acupuncture has been incorporated into the health insurance policies of several countries. Studies have indicated that there have been many recommendations for the use of acupuncture in many clinical practice guidelines published worldwide. Both the number of guidelines recommending acupuncture and the number of acupuncture randomised controlled trials (RCTs) are increasing”

Find Out More

Shaftesbury Clinic provides a free 15 minute consultation (in person, videocall or phone call – all need to be pre-booked). This will enable you to weigh up the research, and aid in your decision about acupuncture as a possible complement to medical treatment

The British Acupuncture Council also has a number of resources for you to take a look at, including a 30-minute documentary about acupuncture

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct complement to usual care – it’s advisable to let your doctor know when you use this approach.

References:

He, Y., Li, J., Li, Y., Jin, R., Wen, Q., Li, N. and Zhang, Y., 2022. Strengthening the quality of clinical trials of acupuncture: a guideline protocol. BMJ open, 12(1), p.e053312. LINK: https://bmjopen.bmj.com/content/12/1/e053312 )

NICE (2021) Chronic pain: Scenario: Management Last revised in April 2021

NIH (2022) https://www.nccih.nih.gov/health/acupuncture-in-depth.

Zhang, Y.Q., Lu, L., Xu, N., Tang, X., Shi, X., Carrasco-Labra, A., Schünemann, H., Chen, Y., Xia, J., Chen, G. and Liu, J., 2022a. Increasing the usefulness of acupuncture guideline recommendations. bmj376. https://bmj.com/content/376/bmj-2022-070533.full

Zhang, Y.Q., Jing, X. and Guyatt, G., 2022b. Improving acupuncture research: progress, guidance, and future directions. BMJ, 376. https://www.bmj.com/content/376/bmj.o487

Helen
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Chronic Pain

Acupuncture and Chronic Primary Pain: the new NICE guidelines

You may have seen the recent press stories about acupuncture being one of the suggested treatments by NICE for the management of chronic primary pain.  This is an interesting headline and is in development, so we thought it would be useful to explain a bit more about what this means, and how it has come about.

What is NICE?

NICE is the NHS advisory body, which looks at the scientific evidence, cost and practicalities of treatment options for specific conditions, and produces guidelines for the NHS doctors and clinicians as to what they should prescribe, and/or where they should refer patients – to consultants or surgery for example.

What is chronic primary pain?

This is condition that is ongoing, and which isn’t caused by another diagnosis or condition.  It is difficult to treat, and can have a big impact on the lives of patients and their families, with many of them being unable to work, and half of them being diagnosed with depression. 

What has NICE said about acupuncture?

Chronic Primary Pain: NICE recommends acupuncture in new draft guidelines, Aug 2020

NICE has said that the emphasis needs to be shifted to place the patient at the centre of the care provision, and makes clear that there is a need to reduce the amount of opioid-based painkillers as a front-line treatment, shifting the long-term care focus toward including non-drug interventions, of which acupuncture is an important one.

NICE stated that commonly used painkilling drugs have little evidence to support their use, and that supervised exercise programmes (cardio, mind-body or a combination) and certain types of psychological therapy (CBT or Acceptance and Commitment Therapy), acupuncture, and some types of antidepressants are more suitable approaches.

What was the evidence for acupuncture?

27 studies showed that acupuncture reduced pain and improved quality of life in the short term (up to 3 months) compared with usual care or sham acupuncture, and was cost-effective, and the quality of this evidence was considered robust enough by the NICE committee for them to recommend that the NHS should use it.

What sort of acupuncture?

The draft guidelines state that both Traditional acupuncture and western medical acupuncture are suitable for this, and that they wish this to be delivered in a community setting (i.e. not in hospital), and by a health practitioner lower than band 7 (i.e. not by a doctor).

What about other physical therapies?

Other manual therapies were not recommended as there was not enough evidence (e.g. osteopathy, chiropractic), and the researchers recommended further research.

What are the new NICE guidelines?

The formal NICE guidelines are set out in a format where they explain when each approach should be used, dosages or length of treatment for example, so it is likely that after these refinements we will know a bit more. They now, since 2021 include acupuncture, as follows:

1.2.5 Consider a single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system,

This is a very encouraging for the following reasons:

High level recognition form an influential health organisation informing NHS policy; the fact that as using a patient-centred approach is beneficial for patients and their families; demonstrates that the increasing, high-quality research evidence for acupuncture is able to support its effectiveness to an extent where the NHS recognise and adopt its usage.

Resources:

British Acupuncture Council Chronic Pain factsheet

References:

UK, N.G.C., 2021: Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline [NG193]Published: 07 April 2021

Helen
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