

Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Community
Ask the community for help and clear up your study doubts
Discover the best universities in your country according to Docsity users
Free resources
Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors
This guideline is based on NICE NG59 Low back pain and sciatica in over 16s. The aim is to provide guidance for clinicians in primary care for pain ...
Typology: Study notes
1 / 3
This page cannot be seen from the preview
Don't miss anything!
Management of Low back pain and Sciatica in primary care Date produced July 2021 Review date June 2024
Introduction This guideline is based on NICE NG59 Low back pain and sciatica in over 16s. The aim is to provide guidance for clinicians in primary care for pain management, with specific recommendations for
management plan and should be used in conjunction with non-pharmacological interventions. Low back pain is pain in the lumbosacral area of the back, between the bottom of the ribs and the top of the legs. Up to 60% of the adult population can expect to have low back pain at some time in their life. Examples of specific causes of low back pain include sciatica, intra-abdominal pathology, or ankylosing spondylitis. Non-specific low back pain refers to when the pain cannot be attributed to a specific cause, although in many cases, may be related to trauma or musculoligamentous strain. Sciatica describes symptoms of pain, tingling, and numbness which arise from impingement/ compression of lumbosacral nerve roots as they emerge from the spinal canal, and are felt in the distribution of the nerve root (dermatome). Episodes of sciatica are usually transient, with rapid improvements in pain and disability seen within a few weeks to a few months. Assessment and Risk stratification Think about alternative diagnoses when examining or reviewing people with low back pain/ sciatica, particularly if they develop new or changed symptoms. Exclude specific causes e.g. infection, trauma or inflammatory disease such as spondyloarthritis. Assess for the presence of red flag symptoms that may suggest a serious underlying causes e.g. Caude equina syndrome or cancer. Do not routinely offer imaging in a non-specialist setting for people with low back pain with or without sciatica. Consider using risk stratification (e.g. STarT Back risk assessment tool) to inform decision making regarding treatment:-
Management of Low back pain and Sciatica in primary care Date produced July 2021 Review date June 2024 Non-pharmacological interventions Options recommended by NICE include group exercise programme, manual therapy and/or psychological therapies (cognitive behavioural approach) as part of a treatment package including exercise. See below referral section for more information. Being active when in pain can be a challenge and it is therefore important for patients to know that it is safe to be active in spite of pain; provide reassurance that pain does not always indicate harm especially when pain persists for a long time. Pharmacological Management For treatments of minor, short-term back pain, patients are encouraged to self-care with lifestyle changes and over-the-counter painkillers e.g. paracetamol, ibuprofen. British Pain Society (BPS) has produced a useful patient information leaflet on managing pain using OTC medicines. Oral NSAIDs