If you've looked into acupuncture, you may have come across the phrase "recommended by NICE". The guidance behind it is carefully worded and quite narrow, so it helps to know exactly what it covers, and what it doesn't.
Who NICE are
The National Institute for Health and Care Excellence (NICE) writes guidance for the NHS in England. Its guidelines weigh up the research on a condition and advise clinicians which treatments to offer, which to consider and which not to use. Most of the recommendations about acupuncture use the word "consider". In other words, acupuncture is a reasonable option to discuss, not a first choice for everyone.
Chronic primary pain (NG193, 2021)
The guideline on chronic pain in people aged 16 and over (NG193) came out in April 2021. It defines chronic primary pain as pain with "no clear underlying condition", or where the pain or its impact is "out of proportion to any observable injury or disease". Examples include fibromyalgia (chronic widespread pain), complex regional pain syndrome, chronic primary headache and orofacial pain, and chronic primary musculoskeletal pain.
Recommendation 1.2.5 tells clinicians to "consider a single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system" for people aged 16 and over to manage chronic primary pain. It comes with conditions about cost. The course should be delivered in a community setting, by a band 7 (or equivalent or lower) healthcare professional with appropriate training, and use no more than 5 hours of that professional's time. Otherwise it can be delivered by someone else or somewhere else "for equivalent or lower cost".
The reasoning was that many studies showed acupuncture reduced pain and improved quality of life in the short term (up to 3 months) compared with usual care or sham acupuncture, but there wasn't enough evidence to judge longer-term benefits. So the recommendation is real, but modest and hedged.
Tension-type headache and migraine (CG150)
The headache guideline, "Headaches in over 12s" (CG150), first appeared in 2012 and was last updated in June 2025. It makes two recommendations about acupuncture.
- Chronic tension-type headache (1.3.9): "Consider a course of up to 10 sessions of acupuncture over 5 to 8 weeks for the prophylactic treatment of chronic tension-type headache." Prophylactic just means preventive, so the aim is fewer headaches rather than treating one that has already started.
- Migraine (1.3.21): if the preventive medicines propranolol, topiramate and amitriptyline "have not worked or are not tolerated or are unsuitable because of safety concerns", the guideline suggests considering a course of up to 10 sessions of acupuncture over 5 to 8 weeks, "according to the person's preference, comorbidities and risk of adverse events".
The 2025 update changed the wording around those migraine medicines, so older articles may quote a slightly different version. The acupuncture course itself (up to 10 sessions over 5 to 8 weeks) hasn't changed.
What NICE doesn't say
The limits matter just as much. For low back pain the guideline (NG59) is clear. "Do not offer acupuncture for managing low back pain with or without sciatica." The NG193 acupuncture recommendation also applies to chronic primary pain only, not pain caused by a known condition such as osteoarthritis. And none of these guidelines is a general endorsement of acupuncture for other health problems.
This guidance is written for NHS decisions, including cost. Choosing private acupuncture is a separate decision, but it's still sensible to see your GP about persistent pain or headaches first, so that other causes can be checked and you know all your options.
How I use this in my clinic
When you come to see me with pain or headaches, I'll talk through what the evidence does and doesn't show, and how a course of treatment might fit alongside the care you already have from your GP. Many people also simply find the sessions calm and unhurried, a bit of time for themselves.
If you'd like to read more about the studies behind these guidelines, have a look at my research page.