Head To Head

Should doctors recommend acupuncture for pain?

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k970 (Published 07 March 2018) Cite this as: BMJ 2018;360:k970

Re: Should doctors recommend acupuncture for pain?

I have been practising acupuncture for 30 years, initially learning in China , while living in Hong Kong.
I also learnt to use it in dental work , doing fillings and tooth extractions successfully under acupuncture anaesthesia, as local drug anaesthesia was more expensive
I also do some steroid injections in both my medical posts,( where the evidence base is inconclusive with small numbers and lack of diagnostic criteria), as it appears to give short term pain relief.
Short term benefit only has been found in shoulder pain,(Buchbinder et al) with a RCT showing no benefits at 12 weeks. Likewise with tennis elbow ,some reduction at 4 weeks with no effectiveness long term in a large multicentre study.
I attended a lecture by a senior physiotherapist 2 years ago where again a conclusive evidence base appears to be lacking.
It is a shame that the focus has been on sham acupuncture used as a placebo in acupuncture trials when other modalities could be used .
I find acupuncture greatly benefits my work, eg in needling deep contracted muscles around joints or treating a severe headache and feel its benefits should be more widely known.

Competing interests: No competing interests

13 March 2018
Rosemary E Alexander
GP+GPSI in rheumatology
Edgware Community Hospital, Edgware , Middlesex HA8 OAD