Tens of millions of pounds are being wasted by the NHS on useless treatments for back pain, money that should be diverted to alternative therapies such as acupuncture and spinal manipulation, according to the government watchdog.
From among 200 treatments and devices claimed to help a bad back, the National Institute for Clinical Excellence (Nice) has passed judgement on what works and what doesn’t. X-rays, ultrasound and steroid injections are out and osteopathy, chiropractic and acupuncture are in, it says.
The new guidelines mark a watershed in the treatment of the condition and for Nice itself. It is the first time that the institute has issued a positive recommendation that the NHS provide and pay for alternative therapies.
The advice, which NHS trusts will be expected to implement over the coming months, is likely to cause controversy among orthodox clinicians who believe NHS money should be reserved for scientifically proven therapies. But Nice says a careful review of the evidence shows that acupuncture and spinal manipulation work.
Back pain is among the most common reasons for visits to family doctors (after colds and flu). It affects one in three adults in the UK each year, with an estimated 2.5 million people seeking help from their GP. The NHS spends £1.5bn on treating the condition, and much of that is wasted on worthless treatments, according to Nice.
The standard advice for people who suffer problems with their back has not changed. It is to continue with their normal activities as far as possible and to avoid bed rest. Most people recover quickly with nothing more elaborate than a couple of paracetamol every four hours to help them keep mobile. The old advice to rest a bad back in bed has been shown to make the condition worse.
The new guideline applies to people with “persistent” low back pain which has lasted for at least six weeks. They should be offered three options: an exercise programme, a course of manual therapy including manipulation or a course of acupuncture. If one treatment option does not work, patients may be offered a second.
Source: The Independent