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preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><p class="vip-notice"><strong><a href="/books/n/niceng59guid/?report=reader">See 2020 Partial Update</a></strong></p><p class="vip-notice retraction"><strong>Guideline updates: December 2020: in the recommendation on stopping opioid analgesics NICE added links to other NICE guidelines and resources that support discussion with patients about opioid prescribing and safe withdrawal management. September 2020: NICE's original guidance on low back pain and sciatica in over 16s was published in 2016. It was partially updated in September 2020. See the NICE website for the guideline recommendations and the evidence review for the 2020 update. This document preserves evidence reviews and committee discussions for areas of the guideline that were not updated in 2020.</strong></p><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="http://www.nice.org.uk/" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng59-lrg.png" alt="Cover of Low Back Pain and Sciatica in Over 16s: Assessment and Management" /></a></div><div class="bkr_bib"><h1 id="_NBK401577_"><span itemprop="name">Low Back Pain and Sciatica in Over 16s: Assessment and Management</span></h1><p><i>NICE Guideline, No. 59</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="http://www.nice.org.uk/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2016 Nov</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-2188-1</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE, 2016.</div><a class="btn wsprkl bkr_rd" href="/books/n/niceng59/fm.s1/?report=reader">Read</a></div><div class="bkr_clear"></div></div><div class="bkr_bottom_sep bkr_bottom_margin body-content whole_rhythm"><div itemprop="description"><h2>Excerpt</h2><p>This guideline covers the assessment and management of low back pain and sciatica in adults over the age of 16 years.</p><p>Low back pain causes more disability, worldwide, than any other condition. Episodes of back pain are usually transient with rapid improvements in pain and disability seen within a few weeks to a few months. Whilst the majority of back pain episodes resolve improve with initial primary care management, without the need for investigations or referral to specialist services, up to one third of patients report persistent back pain of at least moderate intensity one year after an acute episode requiring care and episodes of back pain often recur.</p><p>One of the greatest challenges remains the identification of risk factors that may predict the progression from a single back pain episode to a long term, persistent pain condition where quality of life is often very low and healthcare resource use high.</p><p>A complex and variable interplay between biological, psychological and social factors undoubtedly influences this progression and it is the modification of these factors that has become one of the mainstays of back pain research and treatment over the last decade or so.</p><p>The scope of this guideline is necessarily broad. We have reviewed the evidence for treatments and interventions individually and when used in combination - from self-management advice and simple non-invasive interventions to injections, nerve ablation techniques and spinal fusion.</p><p>We have reviewed the evidence for treatment stratification and the effectiveness of tailoring treatments to these stratified groups in the hope that clinicians know which patients are likely to need more focused and intensive treatment and which patients are likely to improve rapidly with primary care management alone, without the need for investigations or referral to specialised services.</p></div></div></div><div class="fm-sec"><div><p>Developed by the National Guideline Centre, Hosted by the Royal College of Physicians</p></div><div><p><b>Disclaimer:</b> Healthcare professionals are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and, where appropriate, their guardian or carer.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE, 2016.</div><div class="small"><span class="label">Bookshelf ID: NBK401577</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/27929617" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">27929617</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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