New back pain guideline for NHS
2008
Published in October 2008 this guideline will have a significant effect on how back pain is managed in the NHS.
In October, the National Institute for Health and Clinical Excellence (NICE) published the draft guideline for the management of chronic low back pain. This guideline will have a significant effect on how back pain is managed in the NHS.
NICE is an independent organisation that provides guidance for the NHS on promoting good health and preventing ill health. With the help of a team of researchers, clinicians and patients, NICE develops guidelines on what treatments should be provided by the NHS. In the case of the new back pain guideline, BackCare was represented on the guideline development group by Dries Hettinga, BackCare’s Head of Research and Policy.
The task of the guideline development group is to review the scientific literature on the effectiveness and cost-effectiveness of treatments for chronic non-specific low back pain. Based on this review and the consensus amongst the members of the guideline development group, recommendations are drawn up on what treatments should be offered to people seeking NHS treatment for chronic low back pain.
The draft guideline states that in the assessment of this group of people with back pain, MRI scanning should only be used if surgery is considered or there is reason to believe that the pain is caused by an underlying disease or condition. Furthermore, x-rays should not be used in the assessment of this group of patients.
People with non-specific low back pain, which has lasted for more than six weeks but less than one year, should be offered the following core treatment:
- advice to exercise and to maintain a physically active lifestyle, and
- educational materials; and
- a choice between a course of manual therapy, exercise or acupuncture; and
- drug treatment.
If this core treatment does not result in sufficient improvement for the patient, the clinician should consider a referral for a programme consisting of psychological and physical treatment. Further details on the content of the recommended treatments can be found on the NICE website www.nice.org.uk
It is important to realise that, first of all, this is a draft guideline and based on comments received in the consultation period, NICE may change some recommendations. The final guideline will not be out until May 2009. Furthermore, guidelines are not recipe books. Guidelines are a tool for clinicians and patients in deciding what treatment to prescribe and how to manage back pain.
This guideline is an important step towards stopping the ‘postcode lottery’ which determines what services are available to you based on where you live. The guideline will ensure that high quality back pain services are available across the country.
NICE welcomed comments on the draft guideline during the consultation period which ended on 26 November. Since this date is after you will have read this article, BackCare will ask its members their views on this draft guideline in different ways. The final guideline will be available in May 2009.