Acupuncture for low back pain: a survey of clinical practice in the UK
Felicity L Bishop1, Shipu Zaman, George T Lewith
1University of Southampton School of Medicine, Southampton General Hospital, Tremona Road, Southampton, UK. F.L.Bishop@southampton.ac.uk
Objectives:
Acupuncture is recommended in official UK guidelines for persistent non-specific low back pain and is popular with patients. However, what UK-based acupuncturists actually do in every day clinical practice is poorly documented. We therefore conducted a survey of every-day clinical practice of acupuncture for low back pain in the UK.
Design:
Cross-sectional postal survey.
Setting:
Random samples of 100 acupuncturists from each of the three main UK societies for acupuncturists were sent questionnaires.
Main Outcome Measures:
A questionnaire designed (and pilot-tested) for this study asked about: training and professional identity, current work situation, and typical approach to treating a patient with low back pain.
Results:
Completed questionnaires were received from 129 respondents (53% male), representing each society approximately equally. Work situation (e.g. weekly hours practicing acupuncture) differed across societies. Respondents reported needling 2-30 acupuncture points in an average treatment (median=8) and leaving needles in for 0-40 min (median=20 min). A large number of individual points (121) were named as 'typical'.
Conclusions:
There is huge variation in how acupuncture is used by UK practitioners to treat people with low back pain. This probably constitutes a difficult situation for patients when selecting an acupuncturist. It may also translate into large variation in clinical outcomes for patients receiving care from different acupuncturists as well as difficulty in developing acupuncture protocols for pragmatic and other trials. Such diversity reflects the ongoing debate within the acupuncture profession about good practice for common conditions.