Ultrasound, transcutaneous electrical nerve stimulation, routine use of opioids and spinal injections for low back pain (LBP)were ruled out in the document, which was considered for consultation on March 24, 2016. The initial step in dealing with LBP should be all types of exercises, including stretching, strengthening, aerobics and yoga.
It explains that massage and manipulation by a physiotherapist should only be used alongside exercise, as there are no enough evidences supporting theirbenefit when used alone. As per the draft guidance, encouraging people to continue with normal activities as far as possible is recommended. It also encourages flexibility about the content and duration of treatments, revealing that the choices made should consider patient preferences, plus the clinical considerations.
This document is based on an update of the NICE guidance on the early management of LBP which was issued in 2009. The latest guidance was to publish in September 2016. As per professor Mark Baker, clinical practice director of the NICE, ‘Regrettably there is a lack of convincing evidence of effectiveness for some widely-used treatments.
For example, acupuncture is no longer recommended in the management of LBP with or without sciatica. This is because lack of evidences to show that it is more effective than sham treatment’.
Problems related to NSAIDs:
Special concerns were expressed Dave Baker, an independent prescriber and extended scope practitioner based at Homerton University Hospital Trust in London. There are factual issues about using NSAIDs in some patients. So, NICE would advocate their use without suggesting paracetamol first, which generally has far less risk.
|Link to the source:||csp.org.uk/news/2016/03/24/no-more-acupuncture-low-back-pain-
|Original title of article:||No more acupuncture for low back pain, say NICE draft proposals|