This NICE guideline covers assessing and managing low back pain and sciatica in people aged 16 and over. It outlines physical, psychological, pharmacological and surgical treatments to help people manage their low back pain and sciatica in their daily life. The guideline aims to improve people’s quality of life by promoting the most effective forms of care for low back pain and sciatica.
Prescribing recommendations are :
- Consider oral non-steroidal anti-inflammatory drugs (NSAIDs) for managing low back pain, taking into account potential differences in gastrointestinal, liver and cardio-renal toxicity, and the person’s risk factors, including age.
- When prescribing oral NSAIDs for low back pain, think about appropriate clinical assessment, ongoing monitoring of risk factors, and the use of gastroprotective treatment.
- Prescribe oral NSAIDs for low back pain at the lowest effective dose for the shortest possible period of time.
- Consider weak opioids (with or without paracetamol) for managing acute low back pain only if an NSAID is contraindicated, not tolerated or has been ineffective.
- Do not offer paracetamol alone for managing low back pain.
- Do not routinely offer opioids for managing acute low back pain
- Do not offer opioids for managing chronic low back pain.
- Do not offer selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors or tricyclic antidepressants for managing low back pain.
- Do not offer anticonvulsants for managing low back pain.
NICE Bites is a monthly prescribing bulletin from the North West Medicines Information Centre which summarises key prescribing points from NICE guidance.
NICE Bites January 2017; No 93 includes one topic; Low back pain and sciatica in over 16’s.