NIHR Signal Two nerve drugs are not suitable for treating long-term low back pain

The drugs gabapentin and pregabalin (gabapentinoids) were found not to help lower back pain that had lasted more than three months. Gabapentin gave no benefit compared with placebo, while pregabalin was less effective than other painkillers. Both were associated with several side effects, such as dizziness.

From the NIHR Dissemination Centre

NIHR Signal A commonly used treatment does not improve chronic low back pain

This trial found that destroying nerves that take pain signals to the brain using heat (radiofrequency denervation) did not improve pain, function or a sense of “recovery”. The treatment was used alongside exercise and was a variation of the technique commonly used in the UK. In this large study, it was compared to exercise alone.

Low back pain is usually short-lived, but some people develop long-term back pain which can negatively impact their lives. NICE recommends exercise, pain relief and self-management to cope with pain. If these treatments are not effective and pain is severe, then more intensive options, such as radiofrequency denervation can be considered.

From the NIHR Dissemination Centre

London NHS trusts launch ‘back school’ as new care pathway

Two London trusts are launching a 90-minute education session for people with low back pain, as part of a new care pathway to meet the latest clinical guidelines.

Heart of England launches back pain video to promote self-help

Heart of England NHS Trust has launched a video animation with the twin aims of helping people with back pain and reducing the need for hospital treatment.

The animation conveys the message ‘you are the best person to make your back better’. If the back pain is new, you do not need to seek advice from your GP or a therapist, and x-rays and scans are not normally needed because most people recover over time, it says.

It illustrates NHS-approved advice for easing back pain, including keep moving, find a comfortable position, take simple painkillers and anti-inflammatory tablets.

Back pain pilot slashed number of onward referrals

A pilot primary care service in Hertfordshire has managed to discharge 80 per cent of people with low back pain after their first appointment.

Three advanced practice physiotherapists (APPs) delivered the 12-month pilot at the Fairbrook Medical Centre in Borehamwood. It received £75,000 from the Health Foundation to improve patient experience and save money.

Other outcomes from the pilot, which ended in August, included a reduction in waiting times for spinal injections from an average of 31 weeks to just nine weeks.

Low back pain and sciatica in over 16s quality standard

The National Institute for Health and Care Excellence (NICE) has today set out its priorities for implementing guidance on low back pain and sciatica in people over 16.

The quality statements refer to the implementation of updated NICE guidelines, published in 2016.

Depressed patients more likely to be prescribed opioids

Patients with low back pain who were depressed were more likely to be prescribed opioids and receive higher doses, research has found. Understanding these prescribing patterns sheds new light on the current opioid epidemic and may help determine whether efforts to control prescription opioid abuse are effective.

Lateral interbody fusion in the lumbar spine for low back pain

New Interventional Procedures guidance on lateral interbody fusion in the lumbar spine for low back pain in adults. This involves removing the damaged disc and fixing parts of the spine together, to relieve pain.

Low back pain and sciatica in over 16s: assessment and management

This new NICE guideline covers assessing and managing low back pain and sciatica in people aged 16 and over. It outlines physical, psychological, pharmacological and surgical treatments to help people manage their low back pain and sciatica in their daily life. The guideline aims to improve people’s quality of life by promoting the most effective forms of care for low back pain and sciatica.