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Non-specific low back pain is one that is not associated with serious or potentially serious causes. Sciatica is leg pain, secondary to lumbosacral nerve root compression.
The information below is based on the following NICE guideline:
With each new episode of low back pain with or without sciatica, consider using the 9 point STarT Back risk assessment tool to inform shared decision-making
Based on risk stratification, consider:
People with low back pain with or without sciatica should be encouraged to continue with normal activities. Provide advice and information (including the nature of low back pain and sciatica) to help them self-manage at all steps of the treatment pathway.
Consider a group exercise programme (biomechanical, aerobic, mind–body or a combination of approaches) within the NHS for people with a specific episode or flare-up of low back pain with or without sciatica. Take people's specific needs, preferences and capabilities into account when choosing the type of exercise.
Consider manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy.
Consider psychological therapies using a cognitive behavioural approach for managing low back pain with or without sciatica but only as part of a treatment package including exercise, with or without manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage).
Consider a combined physical and psychological programme, incorporating a cognitive behavioural approach (preferably in a group context that takes into account a person's specific needs and capabilities), for people with persistent low back pain or sciatica:
For recommendations on pharmacological management of sciatica, see formulary guidance on management of neuropathic pain.