The updated NICE Guidelines for Low Back Pain and Sciatica no longer recommend acupuncture based on a misunderstanding of the clinical evidence. This decision will limit access to this safe, effective and cost-effective treatment for millions of people, both in the UK and globally.

The authors of the guidelines agree that acupuncture offers 'clinically important benefits in terms of improvements in quality of life' compared to usual care. However, they are side-lining these results and focusing on under-powered studies that compare acupuncture to sham-acupuncture, a clinically irrelevant comparison, and mistakenly using these studies to support the notion that acupuncture has no effect beyond placebo, a conclusion that these studies simply were never designed to support or test.

These same guidelines do recommend the use of non-steroidal anti-inflammatory drugs, even though the most recent Cochrane Review found that the majority of trials found no benefit of NSAIDs over sugar pill for low back pain and that those that did only found a small benefit. Meanwhile, NSAIDs cause 12,000 hospital admissions and 2,600 deaths each year in the UK alone. Moreover, NSAID-related adverse events are estimated to cost the UK between £166-367 million per year, mainly in hospital admissions. These data do not appear to be considered in the economic analysis.

The guidelines are open for consultation until 5 May 2016. We are in the process of drafting a formal response together with other organisations, encouraging a fairer interpretation of the research. But we also feel that the voice of the people affected by these guidelines should be heard. Please encourage NICE to recommend acupuncture for low back pain on the basis of the strong clinical evidence in support of its use.