Manipulation in NICE guidance on low back pain and sciatica.


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NICE updates guidance on low back pain and sciatica


The National Institute for Health and Care Excellence (NICE) has published updated guidance on low back pain and sciatica, including recommending manipulation and massage with exercise in all its forms such as: stretching, strengthening, aerobics and yoga .


The guidelines also recommend encouraging people to continue with normal activities as far as possible.


Acupuncture for treating low back pain is not recommended, as current research has not shown this to be effective, however massage and manipulation with exercise is recommended.


In regards to medication, paracetamol on its own should no longer be the first option for managing low back pain. Instead, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, should be tried first. Weak opioids, such as codeine, are now only recommended for acute back pain when NSAIDs have not worked or are not suitable.


Combined physical treatments (such as Chiropractic) and psychological or talking therapies are recommended for people who have not seen an improvement in their pain on previous treatments, or who have significant psychological and social barriers to recovery.


The updated guidance has been expanded to include people with sciatica, a painful condition typically caused by irritation or compression of the nerves that run from the lower back, through the legs and down to the feet.










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