National Institute for Health and Care Excellence (NICE)
Updated December 2020
TITLE
Low Back Pain and Sciatica in Over 16s: Assessment and Management (NICE Guideline NG59)
National NHS Guideline
SOURCE
https://www.nice.org.uk/guidance/ng59
REFERENCE
1
NICE
REFERENCE
123
organisation
National Institute for Health and Care Excellence (NICE)
Updated December 2020
TITLE
Low Back Pain and Sciatica in Over 16s: Assessment and Management (NICE Guideline NG59)
National NHS Guideline
SOURCE
https://www.nice.org.uk/guidance/ng59
DISC COMMENTARY
NG59 is the national clinical guideline the NHS uses to assess and manage low back pain and sciatica in adults aged 16 and over. It sets out recommended practice across assessment, treatment options and pain relief in primary and specialist care settings.
What was studied?
The guideline reviewed evidence on assessing and treating low back pain and sciatica, including the use of imaging, manual therapy, group exercise, psychological support and pain medicines, to produce recommendations for routine NHS practice.
What did they find?
Routine imaging such as X-ray, CT or MRI is not recommended in general practice, since results rarely change treatment decisions. Instead, group exercise combined with manual therapy, such as manipulation or mobilisation, is recommended, along with clear self-management advice.
Why it matters
Scans are not usually the right first step for back pain or sciatica, since imaging rarely changes treatment. Combining active treatments works better than relying on one approach alone.
Why we included it
It illustrates a wider principle: effective back pain care combines several active treatments and clear self-management guidance rather than relying on imaging or any single treatment as a default first step.
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What was studied?
The guideline reviewed evidence on assessing and treating low back pain and sciatica, including the use of imaging, manual therapy, group exercise, psychological support and pain medicines, to produce recommendations for routine NHS practice.
What did they find?
Routine imaging such as X-ray, CT or MRI is not recommended in general practice, since results rarely change treatment decisions. Instead, group exercise combined with manual therapy, such as manipulation or mobilisation, is recommended, along with clear self-management advice.
Why it matters
Scans are not usually the right first step for back pain or sciatica, since imaging rarely changes treatment. Combining active treatments works better than relying on one approach alone.
Why we included it
It illustrates a wider principle: effective back pain care combines several active treatments and clear self-management guidance rather than relying on imaging or any single treatment as a default first step.