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Low back pain and sciatica

About

What is covered

This pathway covers assessing and managing low back pain and sciatica in people aged 16 and over.

Updates

Updates to this pathway

29 November 2016 Pathway updated, restructured and renamed (previously called low back pain (early management)) on publication of NICE guideline on low back pain and sciatica.

Professional responsibilities

The recommendations in this pathway represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. Applying the recommendations in this pathway is at the discretion of health and care professionals and their individual patients or service users and does not override the responsibility of health and care professionals to make decisions appropriate to the circumstances of the individual, in consultation with them and/or their carer or guardian.
Commissioners and/or providers have a responsibility to enable the recommendations to be applied (and to provide funding required for technology appraisal guidance) when individual health and care professionals and their patients or service users wish to use them. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this pathway should be interpreted in a way that would be inconsistent with compliance with those duties.

Person-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Short Text

Everything NICE has said on low back pain and sciatica in an interactive flowchart

What is covered

This pathway covers assessing and managing low back pain and sciatica in people aged 16 and over.

Updates

Updates to this pathway

29 November 2016 Pathway updated, restructured and renamed (previously called low back pain (early management)) on publication of NICE guideline on low back pain and sciatica.

Sources

NICE guidance and other sources used to create this pathway.
Insertion of an annular disc implant at lumbar discectomy (2014) NICE interventional procedures guidance 506
Peripheral nerve-field stimulation for chronic low back pain (2013) NICE interventional procedures guidance 451
Transaxial interbody lumbosacral fusion (2011) NICE interventional procedures guidance 387
Non-rigid stabilisation techniques for the treatment of low back pain (2010) NICE interventional procedures guidance 366
Percutaneous intradiscal laser ablation in the lumbar spine (2010) NICE interventional procedures guidance 357
Prosthetic intervertebral disc replacement in the lumbar spine (2009) NICE interventional procedures guidance 306
Percutaneous endoscopic laser lumbar discectomy (2009) NICE interventional procedures guidance 300
Automated percutaneous mechanical lumbar discectomy (2005) NICE interventional procedures guidance 141

Quality standards

Quality statements

Effective interventions library

Effective interventions library

Successful effective interventions library details

Implementation

Information for the public

NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.
NICE has written information for the public explaining its guidance on each of the following topics.

Pathway information

Professional responsibilities

The recommendations in this pathway represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. Applying the recommendations in this pathway is at the discretion of health and care professionals and their individual patients or service users and does not override the responsibility of health and care professionals to make decisions appropriate to the circumstances of the individual, in consultation with them and/or their carer or guardian.
Commissioners and/or providers have a responsibility to enable the recommendations to be applied (and to provide funding required for technology appraisal guidance) when individual health and care professionals and their patients or service users wish to use them. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this pathway should be interpreted in a way that would be inconsistent with compliance with those duties.

Person-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Supporting information

Glossary

non-steroidal anti-inflammatory drugs
percutaneous electrical nerve stimulation
transcutaneous electrical nerve stimulation
Pain in the back between the bottom of the rib cage and the buttock creases. A diagnosis of non-specific low back pain simply means that the back pain is very unlikely to be because of a serious problem such as cancer, infection, fracture, or as part of more widespread inflammation.

Paths in this pathway

Pathway created: January 2013 Last updated: November 2016

© NICE 2016

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