NICE guideline for chronic pain: painkillers out, acupuncture in

The National Institute for Health and Care Excellence (NICE) is set to endorse acupuncture as one of only four treatment options GPs can consider prescribing for people with chronic pain conditions. From January 2021, painkillers and all other drugs, apart from anti-depressants, will be off the prescription pad menu.

This new guideline is for chronic primary pain, characterised by emotional distress and functional disability. Common conditions that would qualify are fibromyalgia, myofascial pain, chronic neck pain and chronic pelvic pain, though there are many more possibilities.

This is NICE’s first guideline for chronic pain in general, rather than a specific painful condition, though the equivalent Scottish guideline agency (SIGN) has had one for several years (and it, too, endorses acupuncture).

Which treatments are recommended by NICE in this guideline?

acupuncture

exercise: a supervised group programme, preferably followed up long-term by patients themselves

psychological therapies: specifically cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT)

antidepressant drugs

Ten other classes of medication were considered and rejected by NICE. These included opioids, anti-inflammatories, paracetamol, benzodiazepines and gabapentinoids: none of these were found to have evidence of benefit for chronic pain and there are possible harms associated with their use.

Research shows that acupuncture is one of the best options for chronic pain, and it’s great that NICE recognise what so many patients know from their own experience of treatment.

One of the drivers behind the NICE decision is the urgent need to cut down prescriptions of opioids and other painkillers. In the United States – where opioid addiction is having a devastating impact – acupuncture is an increasingly popular option, supported insurance companies, and for example, a mainstream treatment on offer in healthcare services for US forces veterans .

Acupuncture isn’t only effective for pain, also one of the safest forms of treatment there is, when given by highly trained practitioners. I’m trained to the exacting and stringent standards of the British Acupuncture Council (BAcC). (That’s the membership body I belong to). The BAcC is registered with the Professional Standards Authority (PSA), and although it’s not quite clear yet just how referrals will work once the guidelines are adopted, because we are registered with the PSA, GPs should be able to refer their patients to BAcC members like me for acupuncture for chronic pain (as long as NHS funding allows.)

It is important to realise that this guideline for GPs excludes any condition whose pain management is addressed by existing NICE guidance, that is headaches, low back pain, sciatica, osteoarthritis, rheumatoid arthritis, spondyloarthritis, endometriosis, and IBS. But have a look at the research on how acupuncture can help with these conditions too.

Find some calm: you’re welcome to my online relaxation classes

Everyone needs some space to regroup and nourish the soul at the moment.

Hosted on Zoom at 8pm on Monday evenings, expect 30-minutes of gentle physical and mental relaxation, helping you to find some calm and quiet in these troubling times. 

We’ll do a bit of gentle bodywork to release tension, followed by some calming mindfulness practices.

You can join in the bodywork standing or sitting as you prefer. I suggest loose clothing and you may want a yoga mat or blanket to lie on with a cushion or two to support your back, head or knees.

To register, email me at kaye@kr-acupuncture.com.

If you prefer, you can text me on 07593 058748.

I’ll then send you a link and joining instructions to the Zoom meeting room. You don’t need a Zoom account to take part.

World Acupuncture Day 2018 makes an impact

More than 1,000 delegates gathered at the UNESCO headquarters in Paris for a conference on Thursday 15 November 2018, while in London the British Acupuncture Council held a high-profile press briefing.

The Paris event, organised by the European Traditional Chinese Medicine Association (ETCMA) in conjunction with the World Acupuncture Day Organization (WADO), brought together practitioners, researchers, politicians, academics and administrators of all disciplines related to acupuncture and moxibustion.

In London, acupuncturists, researchers and doctors presented the latest evidence demonstrating the effectiveness of acupuncture to an audience of MPs and journalists, who gathered at the Shard.

Elsewhere in the UK acupuncturists marked the day with a variety of events, ranging from holding taster sessions for charity to writing to their local GPs and MPs.

Chief executive of the British Acupuncture Council, Rob Strange, said: ‘The day was a huge success all round.

‘Many people know about acupuncture because of its ability to help with lower back pain – a huge problem in the UK and indeed the world. But World Acupuncture Day aimed to raise awareness that it is also an effective treatment for many other conditions, including post-traumatic stress disorder, fertility problems, IBS, migraine, depression and the side effects of cancer treatment.

‘When carried out by a fully trained acupuncture practitioner, acupuncture is extremely safe and cost effective and has the potential to transform lives for the better.’

He went on to highlight the importance of promoting acupuncture in the UK.

‘In China, acupuncture is fully integrated into the healthcare system. In Australia it is officially recognised and state registered. The US has a number of integrated programmes where acupuncture is used alongside orthodox medicine.

‘We would like to see acupuncture play a greater role in routine primary care in the UK as it does in other countries. At our press briefing speakers presented some very compelling evidence to show how effective acupuncture is. We are calling on health professionals to examine the science and take steps to integrate acupuncture into their practice.’

Among the speakers at the UK event was consultant cardiologist Sanjay Gupta, from York Hospital, who is collaborating with the Northern College of Acupuncture on a clinical trial to examine the benefits of acupuncture in patients with atrial fibrillation.

Acupuncturist Rebecca Geanty from Norfolk spoke about her multibed clinic, Treat, which helps patients with a range of conditions including musculoskeletal disorders, fertility issues, psychological problems, pregnancy and other chronic conditions.

Adrian Lyster presented on his 25-year career treating patients for pain in hospital and primary care clinics, and extolled the benefits of integrated care.

And Naava Carman presented evidence on the benefits of acupuncture for fertility.

Vice-president of WADO and president of the ETCMA, Gerd Ohmstede, said the Paris event also went extremely well.

He said: ‘One in four EU citizens uses complementary or alternative medicine (CAM), either as a complement or an alternative to conventional care. Yet this increasingly high level of popular use is not reflected in EU or national health policy or provision. 

‘The aim of World Acupuncture Day was to highlight new research that further demonstrates how acupuncture can contribute to national health systems around the world in a safe and cost-effective way.’