Excerpt

This guideline covers the management of persistent or recurrent low back pain defined as non-specific low back pain that has lasted for more than 6 weeks, but for less than 12 months. It does not address the management of severe disabling low back pain that has lasted longer than 12 months.

Contents

• Preface
• Key priorities for implementation
• 1. Guideline recommendations: All recommendations are repeated within the relevant chapter
  • 1.1 Assessment and imaging
  • 1.2 Information, education and patient preferences
  • 1.3 Physical activity and exercise
  • 1.4 Manual therapy
  • 1.5 Other non-pharmacological therapies
  • 1.6 Invasive procedures
  • 1.7 Combined physical and psychological treatment programme
  • 1.8 Pharmacological therapies
  • 1.9 Referral for surgery
• 2. Introduction
  • 2.1 Background
  • 2.2 Aim of the guideline
  • 2.3 How the guideline is set out
  • 2.4 Scope
  • 2.5 Responsibility and support for guideline development
  • 2.6 Care pathway
  • 2.7 Research recommendations
  • 2.8 Acknowledgements
  • 2.9 Glossary
• 3. Methods
  • 3.1 Introduction
  • 3.2 Developing key clinical questions (KCQs)
  • 3.3 Literature search strategy
  • 3.4 Identifying the evidence
  • 3.5 Critical appraisal of the evidence
  • 3.6 Economic analysis
  • 3.7 Assigning levels to the evidence
  • 3.8 Forming recommendations
  • 3.9 Areas without evidence and consensus methodology
  • 3.10 Consultation
  • 3.11 Relationships between the guideline and other national guidance
• 4. Assessment and Imaging of non-specific low-back pain
  • 4.1 Introduction
  • 4.2 Recommendations for assessment & imaging
  • 4.3 X-ray and MRI
• 5. Information, education and patient treatment preferences
  • 5.1 Recommendations for information, education and patient preferences
  • 5.2 Information
  • 5.3 Education
  • 5.4 Patient Preference
• 6. Physical activity and exercise
  • 6.1 Recommendations for physical activity & exercise
  • 6.2 Exercise Advice
  • 6.3 Exercise Programmes
  • 6.4 Group vs Individual Exercise
• 7. Manual therapy
  • 7.1 Introduction
  • 7.2 Recommendations for manual therapy
  • 7.3 Manual Therapy -Effectiveness
  • 7.4 Manual Therapies - Adverse Events
• 8. Other non-pharmacological therapies
  • 8.1 Introduction
  • 8.2 Recommendations for other non-pharmacological therapies
  • 8.3 Electrotherapy Therapies
  • 8.4 Transcutaneous Electrical Nerve Stimulation (TENS)
  • 8.5 Lumbar Supports
  • 8.6 Traction
• 9. Invasive Procedures
  • 9.1 Recommendations for invasive procedures
  • 9.2 Acupuncture and related treatments
  • 9.3 Injections
• 10. Psychological interventions and mixed packages of care (combined physical and psychological interventions)
  • 10.1 Introduction
  • 10.2 Recommendations for combined physical and psychological treatment programme
  • 10.3 Psychological Screening
  • 10.4 Psychological Interventions
  • 10.5 Combined Physical and Psychological Therapy
• 11. Pharmacological therapies
  • 11.1 Introduction
  • 11.2 Recommendations for pharmacological therapies
  • 11.3 NSAIDs
  • 11.4 Opioids
  • 11.5 Antidepressants
• 12. Indications for referral for surgery
  • 12.1 Introduction
  • 12.2 Recommendations for referral for surgery
  • 12.3 Referral for Surgery
  • Reference List

Five NICE guidelines have been included on the Bookshelf as part of a pilot project. All NICE guidance is available on the NICE website at www​.nice.org.uk

Suggested citation:

Savigny P, Kuntze S, Watson P, Underwood M, Ritchie G , Cotterell M, Hill D, Browne N, Buchanan E, Coffey P, Dixon P, Drummond C, Flanagan M, Greenough,C, Griffiths M, Halliday-Bell J, Hettinga D, Vogel S, Walsh D. Low Back Pain: early management of persistent non-specific low back pain. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners.