For what is now called non specific low back which includes Sciatica, NICE (National Institute for Clinical Excellence) in November 2016 produced new updated guidelines which covers assessment and management of low back pain including treatment models for this very common condition.
NICE now recommends for non invasive treatment of non specific low back pain:
- Manual therapy (including Osteopathy) as being a valuable part of multi model package of treatment that should include exercise.
- Non steroidal anti inflammatory should be offered at the lowest dose for the shortest time possible (taking into account risk factors, age etc. to help manage pain control).
One of the new guidelines recommend that the healthcare professions DO NOT offer:
- Imaging in a non-specialist setting for people with low back pain.
The move towards the multi modal approach of jointly agreed care programs including manual therapy, advice on activity and psychological support is not new to the modern Osteopath.
There's no “one size ﬁts all” exercise for a painful lower back, but keeping the two points above in mind at all times can help prevent and relieve the pain, and stop it coming back again.
To help prevent and manage your low back pain the two single most important things you can do are:
- Move – being a ﬁdget will prevent you sustaining poor postures for a prolonged length of time particularly if sitting in front of a computer!
- Look after your lordosis (your lumbar curve) – support the hollow in the small of your back and maintain the ability to arch backwards.
About Low Back Pain and Sciatica
- Low Back pain (LBP) is common in working age adults particularity between the ages of 40-60 years. A UK survey reported in 1998 that 40% of adults had LBP longer than 1 day.
- Treating all types of Back pain costs the NHS more than £1,000 million per year. In 1998 the direct healthcare costs of all back pain in the UK were estimated at £1,623 million 35% of the total spend was services provided by the private sector.
- Sciatica is a relatively common condition with a lifetime instance ranging from 13 to 40% with the corresponding annual incident of sciatica ranging from 1-5%.
- The incidence of Sciatica is mainly related to age, peaking in the 5th decade.
- People who have sciatica usually have pain in the leg.
- Treatment depends on the cause of the nerve impingement as well as the severity of symptoms.