Guideline is misleading

doi:10.1136/bmj.b2735

Published 8 July 2009, doi:10.1136/bmj.b2735
Cite this as: BMJ 2009;339:b2735

Letters

NICE on back pain

Guideline is misleading

The first 100% of the full text of this article appears below.

Is it pure coincidence that the guidelines on early managementof persistent non-specific back pain include as recommendedtreatment options every modality represented by the panel members,but, as no interventionalist sat on the panel, no injectiontreatment?¹ What a horrifying thought to even consider spinalfusion for these patients.

I take comfort in the fact that non-specific back pain by definitionmeans excluding specific contributing factors, and thereforetargeted injections for diagnostic and therapeutic purposesremain an important part of pain practice. It is unfortunatethat the guidelines don’t make this clear.

Cite this as: BMJ 2009;339:b2735

Christian Egeler, consultant anaesthetist and pain specialist¹

¹ Swansea SA6 6L

christian.egeler@swansea-tr.wales.nhs.uk

Competing interests: CE is a pain specialist in a multidisciplinaryteam that includes injection therapy.

Savigny P, Watson P, Underwood M, on behalf of the Guideline Development Group. Early management of persistent non-specific low back pain: summary of NICE guidance. BMJ 2009;338:b1805. (4 June.)[Free Full Text]

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Early management of persistent non-specific low back pain: summary of NICE guidance: Pauline Savigny, Paul Watson, Martin Underwood on behalf of the Guideline Development Group
BMJ 2009 338: b1805. [Extract] [Full Text]