Patients to receive more effective care for lower back pain

From Wednesday 1 November 2017, patients in Leicester, Leicestershire and Rutland who are experiencing lower back pain will now receive more effective care as a result of changes that are being introduced to how the condition is treated.

The changes, being put into place by the three clinical commissioning groups (CCGs) in Leicester, Leicestershire and Rutland together with Leicester’s Hospitals, come in response to new guidance that was published in November 2016 by the National Institute for Health and Care Excellence (NICE) recommending how lower back pain should be treated.

Most back pain gets better by itself, without the need for medical intervention. Actions that patients can take themselves at the first onset of back pain will receive a stronger emphasis in the treatment of back-pain from now on. Patients are recommended to stay as active as possible and return to doing their usual activities gradually. Bedrest should be avoided and patients should continue to go to work.

The local health service has developed a website to help patients who are experiencing lower back pain to help them recover. The site,, contains the latest advice recommended by the local NHS.

If after six to eight weeks there has been no improvement, patients are then encouraged to visit their GP for advice. There will be an increased focus on physical activity and rehabilitation in the community, which has been shown to be very beneficial in tackling back pain and preventing future episodes. Treatments such as acupuncture, electrotherapies (TENS) and spinal injections (excluding epidurals) will no longer to be offered to patients as there is limited evidence of their effectiveness and from 1st November no new patients will be referred to receive them.

There are a range of a range of alternative services that are already available to patients in Leicester, Leicestershire and Rutland, that are recommended by NICE, including physiotherapy, rehabilitation and lifestyle and exercise programmes.

Today, the CCGs have launched and eight-week period of engagement to ensure patients are aware of the changes. The CCGs would also find out from patients who have experienced back pain how these changes will impact them and what they would find beneficial to treat it. The results will be used to inform the development and refinement of back pain treatment options in the future.

Patients can share their views using an online survey Alternatively, a hard copy of the survey can be obtained by contacting Jo Ryder, Head of Engagement and Patient Experience at Leicester City Clinical Commissioning Group on 0116 295 1123. The closing date is 3 December 2017.

Dr Hilary Fox, a GP for East Leicestershire and Rutland Clinical Commissioning Group speaking on behalf of the three local clinical commissioning groups said: “Most people will suffer with low back pain or sciatica at some time in their lives, and for most this can normally be effectively managed by regular exercise and mild pain killers such as ibuprofen.

“For some people however, back pain is a long term condition that has a significant impact on their lives. We know that some commonly used treatments for low back pain, such as acupuncture, electrical stimulation and injections, offer no benefit to patients, and so we are planning to stop offering these treatments, and focus instead on the exercise programs that we know help people to live well with their condition.”

Patients who are currently waiting for a course of acupuncture, electrotherapies and spinal injections (excluding epidurals) will receive a letter explaining their options. They will be able to choose to receive physiotherapy instead, which is recommended by NICE, or continue to wait for their planned treatment.
Patients who are in the process of receiving a course of treatment will be able to continue to receive it this time, but it will not be available to them in the future. They will have their options explained to them when they next attend a clinic.

Clinical commissioning groups (CCGs) are responsible for planning and buying health services on behalf of their population and have a duty to spend public money in the best way possible. They are continually reviewing new guidance and best practice to ensure that the most effective care is being provided to patients and that value for money is being achieved with public funds. There are likely to be changes to the treatment options for other conditions in the future as and when new guidance is published and reviewed.