Low back pain and sciatica: summary of NICE guidance

#### What you need to know Low back pain is the leading cause of long term disability worldwide.1 The lifetime incidence of low back pain is 58-84%,2 and 11% of men and 16% of women have chronic low back pain.3 Back pain accounts for 7% of GP consultations and results in the loss of 4.1 million working days a year.2 More than 30% of people still have clinically significant symptoms after a year after onset of sciatica.4 This guideline replaces the National Institute for Health and Care Excellence (NICE) guideline on early management of low back pain in adults (2009) and expands its remit. It summarises the updated recommendations from NICE for the assessment and management of low back pain and sciatica.5 For a visual summary, please see infographic. It is intended to overcome patchy commissioning of back pain pathways and pain management programmes6 and poor implementation due to clinicians’ beliefs that previous recommendations were constraining clinical practice.7 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence …