May 27, 2009

experts comment on NICE guidelines for lower back pain

The National Institute of Health and Clinical Excellence (NICE) has issued guidelines on NHS provision of alternative and complementary therapies for lower back pain, such as acupuncture and spinal manipulation, and the evidence to support them.

Prof Edzard Ernst, Professor of Complementary Medicine Peninsula Medical School, said:

“This is very over-optimistic as far as chiropractic is concerned. The panel included 3 pro-manipulation experts, including its chair who is the lead author of the UKBEAM trial. As a result, they over-estimated the benefit and under-estimated the risks of chiropractic spinal manipulation, in my view.”

Dr Stuart Derbyshire, Senior Lecturer in School of Psychology, University of Birmingham, said:

“I would be less inclined to offer manipulations and acupuncture even though clinical trials have been successful. These things are hard to do a in a proper randomised and blinded fashion. But anything that encourages back pain patients to stay active, not go for scans and stay out of the hands of surgeons is generally a good thing.”