NICE work: acupuncture coming to a primary care trust near you


When I first set up Merseyside Skeptics, I had only one real rule in mind – “no sacred cows”.

I’m always fascinated by which ideas people hold as their metaphorical cow.  A few years ago, when I first started getting enthusiastic about skepticism, I was ranting in the pub with a doctor friend of mine about homeopathy, crystal healing, iridology, and their friends.  We laughed and joked together about the implausibility of it all and the lack of credible evidence, until I mentioned acupuncture.  Suddenly, his face fell and his tone became more stern. “Actually, acupuncture is effective and there are good scientific reasons for that.”

I was briefly taken aback by this.  My friend is one of the most fiercely scientifically-minded people I know, to the point where he has been accused of bringing down a fun, but daft, conversation by pointing out how daft it is from a scientific stand point.  He was the last person I would have expected to claim efficacy for a pseudomedical practice like acupuncture and looking back now, I should have asked him to explain.  Instead, the subject was dropped, glasses were refilled and conversation breezed on to something else.

As an aside, my doctor friend isn’t the first (and wasn’t the last) person I know to have made positive noises about the efficacy of acupuncture and I can’t help but think it seems to be a particular blind spot for people who are otherwise skeptical of pseudomedicine. Or maybe that’s just confirmation bias on my part.

Back to the plot.

A couple of weeks ago, the Archives of Internal Medicine published the results of a new study which suggested that acupuncture was effective for lower back pain.  In fact, it was so effective that you don’t even have to do any actual acupuncture for it to work; you can play pretend acupuncturist and get results that are just as good.  Steve Novella definitively took apart the conclusions of this study for Science-Based Medicine, and I shan’t attempt to repeat his arguments here. Go read it for yourself. Spoiler: what the data actually says is, acupuncture does not work.

On the heels of this study has come the news that the UK national health watchdog, NICE, have recommended that acupuncture should be made available to NHS patients suffering with lower-back pain.  Specifically, NICE suggest that patients who have suffered with non-specific lower-back pain for more than six weeks should be offered a twelve-week course of one of three “complimentary” therapies: acupuncture, chiropractic or exercise.

Why is this a problem?  Enumeration is always easier, since I don’t have to segue.

  1. This is the first time that NICE has recommended such comprehensive use of pseudomedicine on the NHS; a worrying precedent.
  2. The news comes on the very heels of the Archives study which, despite the conclusions drawn by the authors and reported in the press, very clearly shows that acupuncture is not effective for lower back pain.  You would almost think that the good people down at NICE had uncritically read the press coverage of the study, without actually reading the study itself.
  3. Amusingly, alongside their recommendation to treat patients with placebo-needles and placebo-massage, NICE also recommend that other treatments are dropped to pay for it because… wait for it. Because they aren’t effective.  Oh, the irony!
  4. Hold on, exercise? Since when was doing exercise considered a “complimentary” therapy?
  5. This is a big PR-win for the pseudomedics, who are already being quoted in the press as saying “we always knew our therapies worked”.
  6. If taken up, these recommendations will result in over £40m of tax payers money being paid to acupuncturists, chiropractors and osteopaths.

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  1. #1 by Mykie on May 27, 2009 - 21:10

    Well I’m shocked. NICE are usually really, really rigarous when it comes to their recommendations. There is usually a hefty load of cost/benefit analysis to the point where GPs get really F***ed off by the whole thing. I am struggling to believe crap would get the green light…but argument from personal incredulity aside…I’m shocked!

  2. #2 by Amanda on January 27, 2010 - 18:46

    This polarity (between so-called CAM and so-called good science) is bad science but NICE are just as bad at that (as they deal with commercial science).

  3. #3 by Leon Murray on July 10, 2010 - 07:41

    acupuncture is good for a large number of bodily disorders, i use it to help me ease my rhinitis.~’;

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