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CSP members contribute to review of NICE guideline on low back pain

26 November 2013 - 12:17pm

Proposals from CSP members were included in the society’s response to a National Institute for Health and Care Excellence (NICE) draft scope about clinical practice guidelines on low back pain.

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NICE aims to address the poor implementation of its existing low back pain guidelines

Among the proposals were the need for a holistic assessment of a patient’s condition, including risk stratification, a stepped approach to care and commissioning of services with screening at onset – to identify and manage people at risk of developing chronic low back pain.

CSP professional adviser Ralph Hammond said comments from more than 20 members were included in the society’s response.

‘Thank you to all the CSP members who contributed,’ said Dr Hammond.

‘We welcomed the broad scope of the review, as this is likely to mean that guidelines will be more clinically relevant and more likely to be implemented.’

Client-centred care

The consultation period on the draft scope ended on 18 November. NICE said the aim is to address the poor implementation of its existing guidelines on low back pain.

In its submission, the CSP made detailed suggestions about the timelines for the guidelines. This included proposals on referral thresholds and timelines for patients, supporting the reduction of duration of symptoms to weeks but querying the rationale for two weeks.

The society also recommended considering outcomes, including return to work, patient experience and the prevention of hospital admissions.

Comments and proposals from CSP members included the following:

  • consider the evidence to support the implementation of client-centred care, which can act as the framework to bridge the gap between practitioner and patient and create an equal partnership
  • the growing emphasis on self-care means it is important the scope of the guideline includes evidence for the effectiveness of interventions that educate people with low back pain about active management techniques and strategies
  • the biggest challenge is the patient’s access to timely information. This is partly due to the time taken to access physio services, but also because of inconsistent and often inaccurate information given by a range of healthcare professionals. The CSP argues for the promotion of consistent health messages, particularly re-prognosis, activity/exercise/rest.


A draft of the updated guidelines is expected to be open for consultation in July or August 2015. The anticipated publication date for the completed document is 13 January 2016.

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