Acupuncture, chiropractic and osteopathy all gained official approval in Britain yesterday as treatments for back pain.
The National Institute for Health and Clinical Excellence said the three complementary therapy treatments could be offered to patients with pain in the lower back.
And it said they were preferable to injections of drugs.
NICE’s guidance suggests a range of therapies, including manipulative physiotherapy, but warns doctors to avoid drug-based treatments and x-rays.
First of all patients should be told that the most important treatment for low back pain is staying physically active, it said.
It said patients who chose acupuncture should be offered a course of no more than ten sessions over 12 weeks.
When therapies fail, patients should be offered a programme involving intensive exercise and psychological treatment, it said.
The guidance is aimed at GPs trying to treat people who have been suffering pain from the joints, muscles and ligaments at the back for at least six weeks.
GP Professor Martin Underwood, who helped develop the guidance, said: "This guideline heralds a sea-change in the treatment of low back pain. I am delighted that now, as a GP, I’ll be able to offer my patients a choice of therapies for persistent low back pain that have been shown to work.
"For those patients who don’t improve, I will be able to refer them for intensive treatment that will reduce the misery of living for years with disabling low back pain."
He added: "Importantly, this guideline also gives doctors and other health professionals clear and consistent advice on how to help their patients with persistent back pain."
An NHS osteopath, Steve Vogel, welcomed the new guidance.
He said: "Having been one of a small minority of osteopaths working in an NHS general practice for the last fifteen years, I am excited that many more of the millions of people who suffer from back pain can benefit from the sort of hands-on treatment I provide.
"The guideline recommendations combine giving advice about exercise and activity, with options including hands on treatment by osteopaths, chiropractors, manipulating physiotherapists and acupuncturists. This choice, alongside traditional pain treatments like paracetamol, is essential in enabling people to find something that works for them."
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