Doctors advised to use acupuncture for pain

New guidelines to GPS urge them to prescribe alternative therapies rather than medicinal treatment

Acupuncture should be used instead of opiates to treat chronic pain, new guidance advises. Draft guidelines from the National Institute of Health and Care Excellence said common drug treatments for chronic pain have “little or no evidence that they work”. Instead, it recommends physical exercise, psychological therapy, antidepressants or acupuncture. Health experts recently warned that opioid painkillers do not work for nine in 10 people with chronic pain.

ACUPUNCTURE should be used to treat chronic pain rather than opiates, according to new guidance for GPS and sufferers.

The draft guidelines, released yesterday by the National Institute of Health and Care Excellence, said commonly used drug treatments for chronic pain have “little or no evidence that they work”.

Instead, physical exercise, psychological therapy, antidepressants or acupuncture, should be offered to patients.

Chronic primary pain is a condition that cannot be attributed to another diagnosis and is often characterised by significant emotional distress, such as anxiety or depression, as well as causing disability in daily tasks. It is estimated to affect between one third and one half of the population.

The Nice guidance, which is open for public consultation until Sept 14, recommends that some antidepressants should be considered as treatment, after a review of evidence found they “improved quality of life, pain and psychological distress compared with placebo”. But the committee ruled against the recommendation of pain management drugs, such as paracetamol, non-steroidal anti-inflammatory drugs (which includes aspirin and ibuprofen), benzodiazepines and opioids.

“The lack of evidence for effectiveness of opioids, along with evidence of long-term harm, persuaded the committee to recommend against opioid use for people with chronic primary pain,” the guidance said.

Health experts recently warned that opioid painkillers do not work for nine in 10 people with chronic pain, and urged GPS to be cautious when prescribing them. The guidelines also advise against anti-epileptic drugs, such as local anaesthetics and ketamine, as there was also little evidence that they work, but they could cause harm.

Instead, treatments such as a group exercise programme or cognitive behavioural therapy are recommended. The committee also said “a course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system” should be considered to treat chronic primary pain – but only if it is delivered within a community setting by a healthcare professional. The committee said 27 studies had shown acupuncture reduced pain and improved quality of life in as little as three months, “compared with usual care or sham acupuncture”. But it added there was not enough evidence to assess its longterm effectiveness.

Paul Chrisp, director of the Centre for Guidelines at Nice, said the guidance highlighted the importance of communication when it came to caring for those with chronic pain.