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Worthwhile

The annual economic cost of low back pain in lost productivity and disability or sickness benefits is estimated to be more than £10bn.

Evidence of acupuncture's benefits is largely inconclusive, yet 2% of the UK population uses it in any one year.

Dr Hugh MacPherson, from the University of York, along with colleagues at Sheffield University, reached their conclusions by studying 241 adults with low back pain.

Patients were randomly assigned to either usual NHS care or up to 10 acupuncture treatment sessions. All of the patients remained under GP care.

During the two-year study period, the average total cost of back pain treatment that included acupuncture was £460, compared with £345 for usual care.

Although acupuncture was more expensive, when the investigators took into account the health benefits gained from the treatment in terms of quality and quantity of life, they found it was more than worthwhile for the extra cost.

The cost per quality-adjusted-life-years - or "QALY" - gained was £4,241.

Cost-effective

This is well below the lower threshold of £20,000 used by the National Institute for Health and Clinical Excellence to decide whether the NHS can afford to pay for a health technology, they told bmj.com.

The patients who received acupuncture in the study reported lower pain levels and used fewer pain killers than those who received usual NHS care.

Although the differences in pain scores between groups were small, the study authors say they represent a "clinically worthwhile benefit" and can be viewed as a "moderate" effect.

A Department of Health spokeswoman said it was up to local NHS service providers to decide when to provide acupuncture.

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The government has proposed statutory regulation of acupuncture.

Mike O'Farrell, chief executive of the British Acupuncture Council, said: "Our hope is that after regulation, which is probably 2008, the decision makers will have increased awareness and confidence to offer acupuncture more widely."

Mike Cummings, medical director of the British Medical Acupuncture Society, said there was good evidence that acupuncture was cost-effective and worked beyond placebo.

However, he cautioned that not everyone with back pain would benefit from acupuncture.

The work was commissioned by the NHS Health Technology Assessment programme.