NICE advocates exercise for low back pain

People with low back pain should stay as physically active as possible, and should be provided with advice and information on how to manage their conditions, the government’s health watchdog the National Institute for Health and Clinical Excellence (NICE) has said.

In new guidance on the management of persistent non-specific low back pain, NICE has suggested a structured exercise programme, manual therapy including manipulation or even a course of acupuncture (up to a maximum of 10 sessions) as all potentially good courses of action. But injections of therapeutic substances into the back for non-specific low back pain are not recommended, it added.

Similarly, X-rays of the lumbar spine for the management of non-specific low back pain are not recommended, and practitioners should only offer an MRI scan within the context of a referral for an opinion on spinal fusion.

Persistent non-specific low back pain 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, it said, with around one in three UK adults affected each year.

Professor Peter Littlejohns, NICE clinical and public health director, said: “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.”

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