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GPs buried under trusts' workload dump

Acupuncture benefits back pain long-term

By Emma Wilkinson

Acupuncture has long-term benefits for patients with low back pain and is cost-effective for the NHS, researchers conclude.

The benefits of acupuncture grew over a two-year period, apparently ruling out suspicions that the treatment had only a placebo effect.

Patients referred by GPs for acupuncture had a significant 10 to 15 per cent reduction in pain at 24 months, improved satisfaction and reduced use of analgesics, reported a study published online by the BMJ.

An accompanying economic analysis of the treatment – of an average of eight sessions per patient – showed the cost per QALY was £4,241, well below the NICE cut-off of £20-30,000.

Dr Hugh MacPherson, one of the study researchers and senior research fellow at the University of York, said provision of acupuncture in the NHS was 'very patchy'.

'About three-quarters of patients would like acupuncture on the NHS but only about 10 per cent can access it. There's no way it's going to change without good evidence, but this study is highly relevant for primary care,' said Dr MacPherson.

'We saw a growing benefit at 12 months, which grows again between 12 to 24 months. There is something fundamental going on or you wouldn't see longer-term changes.'

The researchers said 16 per cent of adults consulted GPs every year for low back pain,

indicating the importance of widening access to effective treatments.

Dr Iain Gilchrist, treasurer of the Primary Care Rheumatology Society and a GP in Bishop's Stortford, Essex, said GPs would welcome wider access to acupuncture, particularly for patients resistant to current treatments.

'It would be very useful if it has been shown that acupuncture is effective and cheap; it's just a question of having access to it. There are a few chronic patients who seem resistant to all treatments – they are significant users of NHS resources.'

Dr Brian Crichton, a GP in Solihull, Birmingham and honorary lecturer in therapeutics at Warwick University, said the results were 'thought-provoking'.

'Low back pain is a massive problem for primary care. This is evidence we can share with patients and say there seems to be a continued effect.'

pulse@cmpmedica.com

Acupuncture in numbers

• Acupuncture is used by an estimated 2 per cent of adults each year for a range of conditions

• Only about 10 per cent of patients can access acupuncture on the NHS

• There are more than 2,500 professionally qualified acupuncturists registered with the British Acupuncture Council

• About 16 per cent of the adult population consult their GP with back pain annually

• The annual cost of lower back pain to the NHS has been estimated at £480 million

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