The NICE guideline for ‘Low back pain and sciatica in over 16s: assessment and management’ [NG59] originally published in 2016 has recently been updated. Whilst the guidance on manual therapy remains unchanged, there have been some changes in the recommended pharmaceutical management of this condition, most notably:
- Clinicians are advised not to offer gabapentinoids, other antiepileptics, oral corticosteroids or benzodiazepines for the management of sciatica. They are also encouraged to avoid prescribing opioids for managing chronic sciatica and are encouraged to explain the risks of these medications to patients who are already using them for sciatica.
- The new guidance continues by suggesting that clinicians should be aware of the risk of harms and limited evidence of benefit from the use of NSAIDs for sciatica and to use the lowest effective dose for the shortest possible period of time if these are used.
For the full guidance visit: .nice.org.uk/guidance/NG59/chapter/Recommendations#assessment-of-low-back-pain-and-sciatica