The advice comes in new guidance for persistent, non-specific back pain lasting longer than six weeks, but less than a year.
As a first-line measure, GPs should offer an exercise programme, a course of acupuncture or manual therapy, such as spinal manipulation. For patients with continuing, disabling pain, a more intensive treatment programme should be provided, NICE advises.
The guidelines advise against therapeutic injections and X-ray of the lumbar spine for the management of non-specific low back pain and MRI scans are only recommended in the context of a referral for an opinion on spinal fusion.
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