What are the United Kingdom's National Institute for Health and Care Excellence (NICE) guidelines on lower back pain treatment?

Updated: Aug 27, 2020
  • Author: Debra G Perina, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Similar to the ACP guidelines, the United Kingdom's National Institute for Health and Care Excellence (NICE) guidelines on low back pain prefers nonpharmacologic therapies over pharmacologic pain relief for the initial treatment of back pain. A stratified approach to management based on scores from prognostic screening questionnaires is also recommended in the NICE guidelines. [30]  

NSAIDs are recommended by both ACP and NICE guidelines for treatment of acute and chronic low back pain. The NICE guidelines recommend offering weak opioids to patients with acute low back pain if NSAIDs are contraindicated or ineffective for acute pain, but prescribing opioids for chronic low back pain is discouraged. [30]

The NICE guidelines recommend radiofrequency denervation for selected patients with persistent low back pain. [30] However, the publication of the Mint randomized clinical trials has cast doubt on that recommendation. [41]


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