You can view 5 more pages before signing in

Other treatment options for simple low back pain of more than 6 weeks duration

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

physical activity and exercise
- a structured exercise programme tailored to the person is a therapeutic option:
  - comprises up to a maximum of eight sessions over a period of up to 12 weeks
  - one-to-one supervised exercise programme may be offered if a group programme is not suitable for a particular person
  - exercise programmes may include the following elements:
    - aerobic activity
    - movement instruction
    - muscle strengthening
    - postural control
    - stretching
manual therapy is a therapeutic option
- different manual therapies:
  - a low-amplitude, high-velocity movement at the limit of joint range that takes the joint beyond the passive range of movement
  - spinal mobilisation (joint movement within the normal range of motion
  - massage (manual manipulation or mobilisation of soft tissues)
- duration and frequency of therapy
  - up to a maximum of nine sessions over a period of up to 12 weeks
invasive procedures
- acupuncture is a therapeutic option
  - up to a maximum of 10 sessions over a period of up to 12 weeks
combined physical and psychological treatment programme
- Consider referral for a combined physical and psychological treatment programme, comprising around 100 hours over a maximum of 8 weeks, for people who: have received at least one less intensive treatment (exercise program, manual therapy or acupuncture course) and have high disability and/or significant psychological distress
referral for surgery
- refer consideration spinal fusion who have completed an optimal package of care, including a combined physical and psychological treatment programme and still have severe non-specific low back pain for which they would consider surgery.

NICE note that:

injections of therapeutic substances into the back for non-specific low back pain should not be offered as a treatment option for non-specific back pain

Reference:

1. NICE (May 2009).Low back pain - Early management of persistent non-specific low back pain

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.