In November 2016 the National Institute for Health and Care Excellence (NICE) released updated guidelines for the assessment and treatment of low back pain in adults.
What do the guidelines say?
In reviewing evidence the guidance outlines that a multi-modal approach to the care of patients proves most effective.
In addition to manual therapy and patient exercise/activity, such as through Osteopathy; there is also recognition of the importance of helping patients to regain control through self-management approaches and the role of psychological care.
Where to find the new guidance
The full guidelines are available on the NICE UK website
The Low Back Pain and Sciatica guidelines – in summary
Manual therapy* is recommended as part of a multi-modal package that should include exercise
Exercise is recommended alongside at least one from; manual therapy, self-management or psychological therapy (e.g. cognitive behavioural therapy)
NSAIDS are to be offered for non-specific low back pain at the lowest dose for the shortest time possible (taking into account risk factors, including age)
*Described as manipulation, mobilisation or soft tissue techniques
Low back pain is common in working-age adults (particularly 40-60 years old). A UK survey reported that in 1998, 40% of adults had low back pain lasting longer than 1 day in the previous 12 months.
Treating all types of back pain costs the NHS more than £1000 million per year. In 1998 the direct healthcare costs of all back pain in the UK were estimated at £1623 million.
Sciatica is a relatively common condition with a lifetime incidence ranging from 13 to 40%. The corresponding annual incidence of an episode of sciatica ranges from 1 to 5%.
The incidence of sciatica is related to age. Rarely seen before 20, incidence peaks in our 40’s and then declines.
People who have sciatica usually have pain in the leg, and may also have low back pain. It is most commonly caused by a herniated intervertebral disc, but there are other causes of nerve root impingement in the lower back.
Treatment of sciatica depends on the cause of the nerve impingement as well as the severity of symptoms. In the majority of cases, symptoms caused by a herniated disc resolve with conventional management.
First appointment with an Osteopath? Let’s answer your questions
Many visitors to our clinic have never been to a therapist before, let alone an Osteopath – so there can be some trepidation at what to expect at a first appointment.
Is it all just about ‘clicking’ bones?
Will it hurt?
Do I need to undress?
Our main aim at Rebalance Osteopathy is to address the painful physical issues you came to see us about and formulate a management plan to do that, with your consent. But just as important is to make you feel completely at ease during your visit, so that you feel part of the treatment process – keeping you fully informed throughout the entire appointment.