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BackCare welcomes new NICE guidelines

27 May 2009

Charity welcomes new NICE guidelines on treatment of back pain

BackCare, the charity for healthier backs, has welcomed new guidelines from the National Institute for Health and Clinical Excellence (NICE) on best practice to improve the early management of persistent, non-specific back pain. The guidelines will ensure for the first time high-quality back pain services will be available to anyone accessing NHS services in England and Wales.

BackCare's Chief Executive Sash Newman said: "We welcome these new guidelines. For the first time the patient's choice is central to their treatment. At the charity, through our Helpline and literature we can provide the necessary information to enable patients to make the correct choice for self-help. It is vitally important that an independent organisation like BackCare is able to provide this service."
 
The guidelines recommend exercise, manual therapy or acupuncture as first-line treatments for those with back pain that has lasted more than six weeks. There is then a more comprehensive package of psychological and physical treatments for those who have not recovered after receiving these treatments.

The use of X-rays or injections in diagnosing non-specific back pain is not recommended in the new guidelines. In the vast majority of back pain cases, X-rays and MRI scans do not provide any useful information on where the pain comes from or how it may be treated.
 
BackCare’s Chief Executive Sash Newman continued: “For the first time high-quality back pain services will be available to anyone accessing NHS services for back pain in England and Wales. 

“Previously back pain services were patchy with some examples of very good practice, but also unfortunately many places where people with back pain were not adequately helped by the NHS.

“Most people will benefit from the first-line of treatment options, such as acupuncture, manual therapy or exercise, however the ‘combined psychological and physical programmes’, recommended by NICE will be of great benefit to those who still have significant pain after going through these treatment options.”

“The guidelines state that patient preference is important in choosing between acupuncture, manual therapy and exercise. This is why it is important that patients have reliable information on the options available to them.”

BackCare, in collaboration with NICE, have developed a patient information leaflet that gives people more information about back pain and how they may use the available treatments. BackCare has worked with NICE throughout the development of this guideline and will continue to work on implementation of this guideline across the NHS.

Comments

  • 28th May 2009 at 14:24

    Anonymous

    I am very surprised that BackCare is supporting this NICE guideline. GP's are not qualified to diagnose spinal injuries, and as a consequence should never refer a patient for any kind of "manipulation" (which could aggravate their condition) while the extent of the spinal injury or condition is still unknown, or suggest any other alternative treatment, causing them delay in obtaining the useful medical facts about their spine. Patients must be seen by a qualified orthopaedic or neuro spinal surgeon who would use appropriate diagnostic techniques such as X-Ray & MRI to provide a safe and accurate diagnosis before suggesting any kind of treatment This is a dangerous misguided cost cutting exercise by NICE to cut down on referrals to consultants and avoid X-Ray & MRI costs. It will not help in the long term as patients will suffer for much longer through not receiving the correct advice and treatment in time. As treatment cannot be given before diagnosis in any medical condition patients need to be adamant with their GP that they want a properly qualified diagnosis by a consultant before any treatment is undertaken. You may gather by my tone that I have first hand experience of this situation. This NICE guideline is very irresponsible and worse still goes hand in hand with the February announcement from NICE that "MRI's are no aid to back care" The message being sent out by this guideline is very misleading for patients who have yet to receive a proper diagnosis. I would like to know why BackCare support this guideline.

  • 11th September 2009 at 23:18

    Mr John Chaffey

    What a completely daft idea. About 1 in 5 people have simple low back pain. How can all these people be seen by a surgeon, and what a waste of rescource. Osteopaths and Chiropractors are registered primary care practitioners who are trained to diagnose mechanical back pain and referr for imaging or surgical opinion as required. Extended scope physios also have a similar ability. Cost of surgical route say £100 for consult £500 for MRI and £100 for another consult. £700 and then what do they do . . . refer for manual therapy. Another £200. = £900 Osteopath cost - average 6 treatments £200 job done. MRI's are no aid to back care. They are a pre cursor to surgery. Anonymous should spend some time with a descent manual therapist and see how simple low back pain can be managed safely and efficently.

  • 18th October 2009 at 12:59

    Anonymous

    I welcome the NICE emphasis on making pain management available to all. I've been struggling with increasing back pain, flare-ups and the fear of 'doing more harm than good' for years. Luckily unrelated injury introduced me to the local physiotherapy unit. They referred me to a 3 week, twice weekly back care programme run by the physiotherapy unit at a local sports and leisure centre. Still one week to go, but the benefits are apparent; physically the stiffness and aching is far less, but the biggest change is psychological. I no longer feel fearful, in fact I feel confident that I can control the pain and prevent it from becoming progressively worse. But referral is only via physiotherapy - not GP or hospital - not even orthopaedics. The programme has been running for 8 years yet none of the current participants had heard of it before. The programme was new to the physiotherapist who referred me. This low cost, effective programme should be available to all who need it.

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