This article was updated on 17 Sept 2026.
This is an updated guideline from NICE on the management of low back pain and sciatica. There is quite a bit that is new in this guideline, but it probably doesn’t really add much to our current management. The biggest change is that they don’t advise the use of paracetamol on its own.
In July 26, NICE removed the advice on psychological therapy. CBT is no longer advised either on its own or alongside physiotherapy. This is because part of the evidence that this recommendation was based on has been retracted. It was felt that a full review of the evidence in this area was unlikely to change practice much, so the recommendation was just removed, rather than being updated.
Risk stratify patients
- Use a tool like the STarT Back tool.
- Low risk – less intensive support (eg advice on return to activities, reassurance, self-management).
- Higher risk – more intensive support (eg exercise as below).