New NICE guidelines to help millions of people with low back pain

27/05/2009

Millions of people with low back pain will benefit from new guidance issued to the NHS on the most effective ways to treat this often painful and distressing condition.

 

The National Institute for Health and Clinical Excellence (NICE) and the National Clinical Guideline Centre today (Wednesday 27 May) publish a guideline to improve the early management of persistent non- specific low back pain.  This covers people who have been in pain longer than six weeks but less than one year, where the pain may be linked to structures in the back such as the joints, muscles and ligaments.  Setting out a range of effective mainstream and complementary treatments, the guideline recommends what care and advice the NHS should offer to people affected by low back pain.

 

Affecting around 1 in 3 adults in the UK each year, low back pain is a very common disorder, with an estimated 2.5 million people seeking help from their GP about their condition.  For many people the pain goes away in days or weeks.  However for some, the pain can be distressing and persist for a long time. It is difficult to ‘cure’ low back pain, but the treatments recommended in this guideline can reduce its effect on people’s lives.

 

Professor Peter Littlejohns, NICE Clinical and Public Health Director, said: “Most people will be affected by low back pain at some stage in their lives, so it’s good news that the NHS now has evidence-based guidance on how to treat the condition effectively.   

 

There is variation in current clinical practice, so this new NICE guideline means that for the first time we now have the means for a consistent national approach to managing low back pain. Importantly patients whose pain is not improving should have access to a choice of different therapies including acupuncture, structured exercise and manual therapy.  The recommendations will enable health professionals to provide the best care and advice for people seeking help for low back pain, which should reduce the impact of the condition on patients’ day-to-day lives.”

 

Recommendations from the guideline for health professionals include:

  • Advise people with low back pain that staying physically active as much as possible is likely to help and provide people with advice and information to help them manage their low back pain
  • Offer one of the following treatment options, taking into account the patient’s preference: an exercise programme, a course of manual therapy including manipulation, or a course of acupuncture (more details on each below). Consider offering another of these options if the chosen treatment does not result in satisfactory improvement
  • Consider offering a structured exercise programme tailored to the individual that may include exercises to strengthen muscles, improve posture and stretching
  • Consider offering a course of manual therapy, including spinal manipulation, spinal mobilisation and massage.  Treatment may be provided by a range of health professionals including chiropractors, osteopaths, manipulative physiotherapists or doctors who have had specialist training
  • Consider offering a course of acupuncture needling, up to a  maximum of 10 sessions over a period of up to 12 weeks
  • Injections of therapeutic substances into the back for non-specific low back pain are not recommended
  • Offer a combined intensive exercise and psychological treatment programme for people who have had at least one less intensive treatment already, but who still have disabling pain which causes significant distress or seriously impacts on daily life
  • Do not offer X-ray of the lumbar spine for the management of non-specific low back pain, and only offer an MRI scan within the context of a referral for an opinion on spinal fusion.

The guidance is available at the website linked below.

Relevant links

Send this page to a friend