NICE low back pain guidelines: opportunities and obstacles to change practice

The National Institute for Health and Care Excellence recently updated its low back pain (LBP) guidelines,1 with the associated infographic developed to assist interpretation of the recommendations. The guidelines are more consistently aligned with Cochrane systematic reviews than the previous version. The guidelines contain several key directives, which, if widely implemented, could significantly impact on the care of individuals with LBP. Established evidence-based messages, including the need for more cautious referral for some investigations and treatments including imaging, medication and surgery, are reinforced, with a clear emphasis on facilitating self-management strategies. Considering psychosocial factors at an early stage is also advocated, rather than waiting for usual care to fail. There is a timely shift to targeting care based on a person’s multidimensional risk profile, rather than merely symptom duration.