Cited by 399Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPregnancy-related medical research

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Low back pain and sciatica: summary of NICE guidance

Bernstein, Ian A, Malik, Qudsia, Carville, Serena, Ward, Stephen·2017·BMJ

DOI 10.1136/bmj.i6748

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Abstract

#### 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 …

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A Heavy Burden: the occurrence and impact of musculoskeletal conditions in the United Kingdom today.
Parsons, S., Ingram, M., Clarke-Cornwell, A. M., & Symmons, D. P. M. (2011) · Cited by 27

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Additional file 1 of Breaking the cycle of reoccurring low back pain with integrated motivational interviewing and cognitive behavioural therapy to facilitate education and exercise advice: a superiority randomised controlled trial study protocol
Watson, E. D., Marshall, P. W., Morrison, N. M. V., Moloney, N. A., O’Halloran, P., Rabey, M. I., Niazi, I. K., Stevens, K., & Kingsley, M. (2024) · Figshare · doi:10.6084/m9.figshare.26952298
Additional file 1 of One size does not fit all: Participants’ experiences of the selfBACK app to support self-management of low back pain—a qualitative interview study
Svendsen, M. J., Nicholl, B. I., Mair, F. S., Wood, K., Rasmussen, C. D. N., & Stochkendahl, M. J. (2022) · Figshare · doi:10.6084/m9.figshare.21266874
Additional file 4 of Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire
O'Hagan, E., Skinner, I., Jones, M. D., Karran, E. L., Traeger, A. C., Cashin, A. G., Wand, B. M., Schabrun, S. M., O’Neill, S., Harris, I. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18132330
Additional file 2 of Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire
O’Hagan, E. T., Skinner, I., Jones, M. D., Karran, E. L., Traeger, A. C., Cashin, A. G., Wand, B. M., Schabrun, S. M., O’Neill, S., Harris, I. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18132324
Additional file 5 of Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire
O’Hagan, E. T., Skinner, I., Jones, M. D., Karran, E. L., Traeger, A. C., Cashin, A. G., Wand, B. M., Schabrun, S. M., O’Neill, S., Harris, I. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18132333
Additional file 1 of The association between early MRI and length of disability in acute lower back pain: a systematic review and narrative synthesis
Shraim, B. A., Shraim, M. A., Ibrahim, A. R., Elgamal, M. E., Al-Omari, B., & Shraim, M. (2021) · Figshare · doi:10.6084/m9.figshare.17079257
Additional file 2 of Complex return to work process – caseworkers’ experiences of facilitating return to work for individuals on sick leave due to musculoskeletal disorders
Løchting, I., Grotle, M., Storheim, K., Foldal, V. S., Standal, M. I., Fors, E. A., & Eik, H. (2021) · Figshare · doi:10.6084/m9.figshare.14433116
Additional file 2 of Knowledge, beliefs, and attitudes of spinal manipulation: a cross-sectional survey of Italian physiotherapists
Mourad, F., Yousif, M. S., Maselli, F., Pellicciari, L., Meroni, R., Dunning, J. R., Puentedura, E., Taylor, A., Kerry, R., Hutting, N., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21087522
Additional file 2 of Breaking the cycle of reoccurring low back pain with integrated motivational interviewing and cognitive behavioural therapy to facilitate education and exercise advice: a superiority randomised controlled trial study protocol
Watson, E. D., Marshall, P. W., Morrison, N. M. V., Moloney, N. A., O’Halloran, P., Rabey, M. I., Niazi, I. K., Stevens, K., & Kingsley, M. (2024) · Figshare · doi:10.6084/m9.figshare.26952301
Additional file 1 of Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire
O’Hagan, E. T., Skinner, I., Jones, M. D., Karran, E. L., Traeger, A. C., Cashin, A. G., Wand, B. M., Schabrun, S. M., O’Neill, S., Harris, I. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18132321
Additional file 2 of The association between early MRI and length of disability in acute lower back pain: a systematic review and narrative synthesis
Shraim, B. A., Shraim, M. A., Ibrahim, A. R., Elgamal, M. E., Al-Omari, B., & Shraim, M. (2021) · Figshare · doi:10.6084/m9.figshare.17079260
Additional file 3 of Complex return to work process – caseworkers’ experiences of facilitating return to work for individuals on sick leave due to musculoskeletal disorders
Løchting, I., Grotle, M., Storheim, K., Foldal, V. S., Standal, M. I., Fors, E. A., & Eik, H. (2021) · Figshare · doi:10.6084/m9.figshare.14433119
Additional file 1 of Knowledge, beliefs, and attitudes of spinal manipulation: a cross-sectional survey of Italian physiotherapists
Mourad, F., Yousif, M. S., Maselli, F., Pellicciari, L., Meroni, R., Dunning, J. R., Puentedura, E., Taylor, A., Kerry, R., Hutting, N., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21087519
Additional file 1 of Complex return to work process – caseworkers’ experiences of facilitating return to work for individuals on sick leave due to musculoskeletal disorders
Løchting, I., Grotle, M., Storheim, K., Foldal, V. S., Standal, M. I., Fors, E. A., & Eik, H. (2021) · Figshare · doi:10.6084/m9.figshare.14433113
Additional file 3 of Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire
O'Hagan, E., Skinner, I., Jones, M. D., Karran, E. L., Traeger, A. C., Cashin, A. G., Wand, B. M., Schabrun, S. M., O’Neill, S., Harris, I. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18132327
Additional file 3 of The association between early MRI and length of disability in acute lower back pain: a systematic review and narrative synthesis
Shraim, B. A., Shraim, M. A., Ibrahim, A. R., Elgamal, M. E., Al-Omari, B., & Shraim, M. (2021) · Figshare · doi:10.6084/m9.figshare.17079263
Additional file 2 of One size does not fit all: Participants’ experiences of the selfBACK app to support self-management of low back pain—a qualitative interview study
Svendsen, M. J., Nicholl, B. I., Mair, F. S., Wood, K., Rasmussen, C. D. N., & Stochkendahl, M. J. (2022) · Figshare · doi:10.6084/m9.figshare.21266877
Additional file 3 of Breaking the cycle of reoccurring low back pain with integrated motivational interviewing and cognitive behavioural therapy to facilitate education and exercise advice: a superiority randomised controlled trial study protocol
Watson, E. D., Marshall, P. W., Morrison, N. M. V., Moloney, N. A., O’Halloran, P., Rabey, M. I., Niazi, I. K., Stevens, K., & Kingsley, M. (2024) · Figshare · doi:10.6084/m9.figshare.26952304
Additional file 3 of Knowledge, beliefs, and attitudes of spinal manipulation: a cross-sectional survey of Italian physiotherapists
Mourad, F., Yousif, M. S., Maselli, F., Pellicciari, L., Meroni, R., Dunning, J. R., Puentedura, E., Taylor, A., Kerry, R., Hutting, N., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21087525
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Authors: Bernstein, I. A., Malik, Q., Carville, S., & Ward, S.
Affiliations: London North West Healthcare NHS Trust (GB)
Royal College of Physicians (GB)
Brighton and Sussex University Hospitals NHS Trust (GB)
ORCID: Bernstein, Ian A
Carville, Serena
Ward, Stephen
Venue: BMJ
Publisher: BMJ
Published: 2017-01-06
Volume: 356
Pages: i6748
ISSN: 1756-1833 (ISSN-L)
0959-8138
DOI: 10.1136/bmj.i6748
OpenAlex: W2568605285
Cited by: 399
References: 2
Citations by year: 2026: 23 · 2025: 35 · 2024: 45 · 2023: 60 · 2022: 47 · 2021: 52 · 2020: 48 · 2019: 43 · 2018: 35 · 2017: 9
FWCI: 26.02
Type: journal article
Language: en
Update notices: correction (2021-07-14)
Open access: closed
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
Locations: BMJ (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: low back pain, sciatica, NICE guidelines, chronic back pain, back pain management, clinical evaluation, pain management program, implementation of clinical recommendations, cost-effectiveness
MeSH terms: Humans, Sciatica, Randomized Controlled Trials as Topic, Low Back Pain, Practice Guidelines as Topic

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Low back pain and sciatica: summary of NICE guidance

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