Early management of persistent non-specific low back pain: summary of NICE guidance

Most episodes of acute low back pain resolve spontaneously.1 However, among those in whom low back pain and disability have persisted for over a year, few return to normal activities. Thus the focus for preventing the onset of long term disability caused by non-specific low back pain is on the early management of persistent low back pain (pain present for more than six weeks and less than one year). No consensus exists on how to help health professionals and their patients choose the best treatments for this condition. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the early management of non-specific low back pain.1 The diagnosis of specific causes of low back pain (malignancy, infection, fracture, ankylosing spondylitis, and other inflammatory disorders) is not part of this guideline. NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. The box lists treatments that should not be offered for non-specific low back pain. #### Treatments not recommended for non-specific low back pain ##### Do not offer