A Critical Look into the 2016 NICE Guidelines: Acupuncture for Low-Back Pain and Sciatica

Abstract

Abstract Background: In November of 2016, the National Institute for Health and Care Excellence (NICE) Guidelines for low-back pain (LBP) and sciatica were published. According to the NICE Guidelines Development Group (GDG), acupuncture is no longer a recommended treatment for LBP and sciatica, while other therapies including nonsteroidal anti-inflammatory drugs, exercise, epidurals, and manual therapy are recommended as treatments. Objective: The aim of this article is to discuss how the GDG decision-making process behind the recommendations against acupuncture—while supporting common conventional treatments for LBP and sciatica—is inconsistent and lacks sufficient evidence-based justification. Methods: The evidence used to develop the 2016 NICE Guidelines for LBP and sciatica were critically appraised using the Grading of Recommendations, Assessment, Development, and Evaluation framework, and examined for their limitations. Results: There is predominantly moderate-quality evidence favoring acupuncture o...