Exercise, including yoga, is the best medicine for a healthy lower back according to new draft guidelines from NICE (National Institute for Health and Care Excellence).
It is recommending specialised yoga classes, as well as stretching, strengthening and aerobics as best treatment options for early management of low back pain.
The guidance also advises encouraging people to continue with normal everyday activities for as long as possible.
Other changes include dropping acupuncture as a treatment option for low back pain as NICE says there is insufficient evidence to show it is effective. Paracetamol on its own is no longer the first option as a painkiller. Instead ibuprofen or aspirin should be tried first with weak opioids, such as codeine only recommended for acute back pain if these haven’t worked.
Musculoskeletal physician and GP Dr Ian Bernstein, a member of the group developing the guidelines, said: “There’s an emphasis in supporting self-management and in promoting active treatment such as exercise in all its forms, rather than passive treatment, such as manual therapy which is only recommended alongside exercise.”
Alison Trewhela from the Yoga for Healthy Lower Backs Institute welcomed the new proposals, which endorse the findings of its large research trial, funded by Arthritis Research UK and led by the University of York. She said: “It showed a specialised yoga programme to be significantly effective for GP patients and cost-effective within an NHS setting (H. Tilbrook et al, 2011 Annals of Internal Medicine; H.L.Chuang et al, 2012 Spine journal). This specific ‘best practice’ ‘Yoga for Healthy Lower Backs’ 12-week group yoga course is available throughout the UK taught by 400 highly qualified, trained and regulated teachers. With its educational materials and continuity of ‘care’, this gentle beginners’ programme aims to teach patients to self-manage for the long-term, helps people to feel more in control of their health, and was shown to reduce work absenteeism by 70% over the 12 months studied.”
The Yoga for Healthy Lower Backs programme is taught on Monday evenings at Studio Yoga, where owner Tamsin Kelly is only one of three teachers in Hampshire qualified to teach the specialist classes.
A recent study found that lower back pain caused more disability than any other condition, affecting 1 in 10 people and becoming more common with increasing age.
In the UK it is estimated that low back pain is responsible for 37% of all chronic pain in men and 44% in women and the total cost of low back pain to the UK economy is reckoned to be over £12 billion per year.
The new guidelines, which are expected to be published in September, will replace those last issued in 2009, and now cover low back pain no matter how long it has been experienced, rather than just long-term pain.