RESEARCH ROUNDUP

In the UK, the cost of treating low back pain in general practice alone was an estimated £3.2 billion in 2015, and in 2017 the NICE published their clinical care standard emphasising priority areas for healthcare quality improvement for the management of low back pain and sciatica.

In this editorial, however, Oliveira et al (2025) assert that ‘health service planners, clinicians and patients are not well served by the 2017 NICE standard.’ For example, the standard recommends risk stratification for new acute episodes, but trials have failed to demonstrate any benefit of risk stratification when managing patients with low back pain or sciatica. Another recommendation promotes self-management, but ‘three recent trials have shown this approach results only in modest effects’.

A further statement recommends radiofrequency denervation for persistent low back pain, although the current evidence shows mixed results in terms of efficacy.

Oliveira et al also note that the NICE standard does not refer to an intervention for persistent or recurrent low back pain, even though these cases are the most costly to health systems and society, and the forms of low back pain that are reported by clinicians as the most challenging to manage.