New back pain guidelines – what does it all mean?


Are you wondering what to do for the best for your back pain? Well the National Institute for Health Care and Excellence (NICE) guidelines for the early management of low back pain (2009) are currently under review with some interesting changes!


Health care practitioners use these guidelines to keep on top of best practice to ensure their patients receive the best care and treatment. This keeps their fingers on the pulse of the current evidence base which is crucial for physiotherapists.


Here at Bespoke Physiotherapy, we are extremely interesting in these up and coming revised guidelines as low back pain is single handed the most common injury we see in our busy Central London, Covent Garden clinic.


So what treatments are we doing right that is not changing?


Exercise, exercise and more exercise! Whether it is specific physiotherapy exercises, normal daily activity or even aerobic exercise or yoga; exercise is still the first and most crucial step in managing low back pain.


Running strength Exercise - Bridging 2. Bespoke Physiotherapy Covent Garden London


Hands-on treatment, such as massage and manipulation by your physiotherapist, should always be used alongside home exercises because there is not enough evidence to show they are of benefit when used alone.

Combining physical and psychological treatments (i.e. talking therapies) are recommended for patients who have not seen an improvement in their pain on previous treatments or who have psychological and social barriers to recovery (i.e. low mood or anxiety).


What has been put on the back burner when managing back pain?

The guidance no longer recommends acupuncture for treating low back pain as there is limited evidence to support its benefit when compared to a control sham group.



Paracetamol was previously the first option for managing low back pain however, the new draft guideline recommends that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin should be tried first. Weak opioids, such as codeine, are now only recommended for acute back pain when NSAIDs haven’t worked or aren’t suitable.


Why come and see us at Bespoke Physiotherapy?


All the physiotherapists at Bespoke Physiotherapy are highly skilled and trained at identifying the root causes of low back pain and can help you restore function and activity as soon as possible. We also have the full use of the Oasis Sports Centre multi gym to use during your treatment sessions to ensure that you can exercise safely whilst your injury recovers.


Our physiotherapists are also extremely good listeners and can help you decide whether additional psychological treatments may compliment your physical treatment plan. They are confident to refer you on to such services and can liaise with you GP as required.


consult 2

What are the key points to take away for both physiotherapists and back pain sufferers?

  • The best treatment for low back pain is to keep up with normal activities and to exercise as pain allows.
  • Be open minded to talking therapy if you pain persists despite treatment or if you feel you are experiencing symptoms of low mood or anxiety, as this can help expedite recovery alongside your physical therapy.
  • Liaise with your GP for analgesia support, which can be progressed to Codeine based medication should the anti-inflammatories not be effective.

If you have any concerns or questions regarding your back pain or recovery, please feel free to contact our team on

Written: 23rd June 2016 by Clare Henson-Bowen, Director and Principal Physiotherapist at Bespoke Physiotherapy in Covent Garden, Central London