Referral

Back
Policies Toggle Pages
Abdominal hernia in adults Adult Snoring Surgery (in the absence of Obstructive Sleep Apnoea) Arthroscopic shoulder decompression for subacromial shoulder pain Arthroscopic surgery for meniscal tears Artificial urinary sphincters for post-prostatectomy incontinence Assisted Conception Benign Skin and Subcutaneous Lesions Commissioning Policy Blepharoplasty (upper and lower lid) including brow lift Botulinum Toxin A for the management of focal hyperhidrosis Breast implants - removal and replacement Breast reduction surgery Carpal tunnel syndrome (surgery) Cataract Surgery Chronic rhinosinusitis with or without polyps Circumcision Cosmetic Treatments Cryopreservation to Preserve Fertility Dilatation and curettage for heavy menstrual bleeding in women Dupuytren's contracture treatment Ear Wax Removal Femoro–Acetabular Impingement, open or arthroscopic surgery Fusion surgery for non-specific, mechanical back pain Haemorrhoids in adults Hallux Valgus (Bunion) - Commissioned pathway Heavy Menstrual Bleeding - Referral for Surgical Management Hip and knee replacement surgery in obese patients (those with a body mass index of 30 or greater) Individual Funding Requests (IFRs) Injections for non-specific low back pain without sciatica Knee arthroscopy for patients with osteoarthritis Lumbar spine procedures – for simple lumber back pain Meibomian cysts (chalazia) Myringotomy/grommets and adjuvant adenoidectomy for the management of otitis media in children under 12 years Myringotomy with and without grommets in adults and children aged 12 years+ Open Magnetic Resonance Imaging (MRI) Scanning Radiofrequency Denervation Reversal of male and female sterilisation Spinal injections for sciatica Surgery for ganglion cyst Surgical procedures for the treatment of LUTS caused by BPH Tonsillectomy Trigger finger release in adults Varicose vein referral
Print this page
Contact us about this page

Lumbar spine procedures – for simple lumber back pain

This is a summary of the NHS Devon commissioning policy for Lumbar Spine Procedures – for simple lumbar back pain

This guidance is intended for simple lumbar back pain. It does not cover suspected malignancy, or nerve root compression

Toggle all

History and Examination

Patient presents with acute lumbar back pain:

  • Full history is taken to exclude any comorbidities

Conservative treatment consisting of:

  • Muscle relaxants
  • Analgesics
  • Education regarding lifestyle including where appropriate, weight loss, physical activity

If pain continues:

  • consider injection therapy including steroid and epidural injections where appropriate
  • refer to physio if appropriate for posture assessment / training

If patient has not resumed usual activity levels after 3 months refer to specialist service which could include:

  • back pain physio specialist
  • psychological input
  • pain management team

If patient has not resumed usual activity levels after multi-disciplinary treatment consider referral to specialist

Referral Criteria

Surgery for lumbar back pain should only be considered after the full range of primary care interventions has been used.

Referral for consideration of surgery should only occur if the patient fulfils the following criteria:

  • Has received conservative treatment including:
  • Muscle relaxants
  • Analgesics
  • Posture assessment / training
  • Education re lifestyle including where appropriate, weight loss, physical activity
  • Injection therapy including steroid and epidural injections where appropriate
  • Referral to a multi-disciplinary back-care team
Back to Top