NICE low back pain guideline marks an important moment for the profession

CSP chief Karen Middleton explains why the latest NICE guideline on low back pain is incredibly important for all physiotherapy staff working in the musculoskeletal field.

by Karen Middleton

As with any new recommendation, the low back pain guidance from NICE issued today, will provoke debate. But it is essential to recognise that this publication offers major opportunities and marks an important moment for our profession.

The guidance calls for a person-centred approach and puts individually-tailored exercise as a key intervention.

This is significant because the expertise physiotherapists have puts us in a strong position to be the key profession in the management of low back pain.

Indeed, reference to physiotherapy in the guideline is an acknowledgment that we are expected to take that leading role.

At a time when services are having to justify their existence – both in the NHS and elsewhere – this is a vital basis on which to make that case.

More broadly, however, the guidance also offers the opportunity to evolve as a profession, looking again at our practice and re-evaluating what is best for our patients.

This can be a challenging thing to do, but it is an integral part of the development of any profession.

There will of course be members who are disappointed that acupuncture is not recommended as a treatment for back pain. We recognise those feelings and take perhaps a slightly nuanced view on what should be accepted as evidence (see the CSP's position statement on evidence based practice). But the process has now concluded and a decision has been reached.

Of course, guidelines are not tramlines and should not be treated as such.

Patient preference and clinical experience should always be taken into account alongside the evidence, but equally, within the NHS, services can only be provided which are being commissioned.

I would recommend all physiotherapy staff treating people with low back pain read the guideline.

You can see the rationale behind the recommendations, as well as the process that led to the development of the guidelines.

A key part of that process was the consultation, which the CSP submitted a response based on member input.

You can also view NICE’s responses to the consultation comments, and reading this additional material can help you see the full picture and context in which the recommendations are made.

Whatever your take on the guideline, the reality is that is has now been published and we must seize the opportunities it presents.

We know how important it is for patients to have access to high-quality physiotherapy services and the recommendations give us the backing to making that happen across the country.

Please read them, reflect and then set about putting them into practice.

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