Whether acupuncture works is not the issue here(1). Patients in their hundreds of thousands find it to work(2). NICE certainly found it to work In terms of superiority over no acupuncture/usual care, in fact no other non-drug therapy works better(3). Perhaps even more impressive is the sham controlled evidence. Despite sham acupuncture being another active acupuncture intervention this still produced a 0.8 SD superiority on the pain VAS from plentiful high quality data. No other non-pharmacological treatment was even at the races here, and, of the seven classes of drugs evaluated, only one (NSAIDs) did better (slightly: 1.0 SD). Rightfully concerned that NSAID adverse events might be a bit much for some patients to swallow, NICE decided to pick a back-up treatment. Was this the second placed runner, the rather safe acupuncture? No, they chose opiates (0.6 SD).