Clinical Practice Guidelines of Acupuncture for Low Back Pain : A Comparison of those of the UK and USA

Abstract

Low back pain (LBP) is one of the most common complaints of Japanese citizens, and is a symptom for which acupuncture has been applied since ancient times. We empirically recognize that acupuncture is effective for LBP, but in recent years, it became necessary to show evidence regarding its efficacy and effectiveness.

Currently, to elucidate the effect of a medical intervention, randomized controlled trials (RCTs) are considered the gold standard and outcomes of RCTs are integrated as a systematic review (SR), and these are used to establish the degree of recommendation in the clinical practice guidelines (CPGs). Eventually, practitioners make their clinical decisions according to the recommendations in CPGs.

In this report, the author compared CPGs of acupuncture for LBP between those of the United Kingdom (UK) and United States of America (USA). The NICE guideline development group of the UK did not fully understand Japanese-style acupuncture, and they considered clinical trials with placebo/sham as a control to be the most important, leading to underestimating the effect of acupuncture. On the other hand, the ACP guideline of the USA considers clinical trials with conventional treatment as a control to be more important, and accordingly the effect of acupuncture was evaluated realistically.