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What should you avoid when treating lower back pain?


NICE have published new guidelines(1) discussing treating lower back pain in people who have had back pain for more than one week but less than one year.  This section talks about what they say you should avoid when deciding on treatment for back pain.

In this article

Injections are not recommended

To start with injections into the back are not advised, this will upset many people who think they are helpful, but the research we have really does not support the usefulness of them.

Electrical Treatments don’t work either

Laser therapy, Interferential therapy, Therapeutic ultrasound, TENS, all get the thumbs down too.  The only one on this list I was surprised about was TENS, but I suppose on reflection I would probably mainly use that with people who have had pain for longer than a year.

Lumbar supports and traction

Nope, these longstanding treatments are also rejected.  This hasn’t surprised me as the research about the lack of effectiveness of these treatments has been there for a long time. We have known for example that traction is unhelpful for years. What surprises me is that people keep getting offered these treatments.

 Should you consider lower back surgery for this problem?

The guidelines are clear that lower back surgery (spinal fusion) is really a last option and should only be considered if you have completed all the treatments for back pain mentioned above. If your back pain is still so severe that you would consider surgery with all its associated risks then you need to discuss your problem with a surgeon.

References

1.         NICE Low back pain. <http://guidance.nice.org.uk/CG88>

Lower back pain treatment hub page

Lower Back Pain Toolkit Home Page

November 23, 2012