Injections for non-specific low back pain without sciatica

This is a summary of the NHS Devon CCG commissioning policy for Injections for non-specific low back pain without sciatica

Referral

Referral Criteria

Spinal injections of local anaesthetic and steroid are not routinely commissioned in Devon for patients with non-specific low back pain.

For people with non-specific low back pain the following injections should not be offered:

  • facet joint injections
  • therapeutic medial branch blocks
  • intradiscal therapy
  • prolotherapy
  • Trigger point injections with any agent, including botulinum toxin
  • Epidural steroid injections for chronic low back pain or for neurogenic
  • claudication in patients with central spinal canal stenosis
  • Any other spinal injections not specifically covered above

Radiofrequency denervation can be offered according to National Institute for Health and Care Excellence (NICE) guideline (NG59) if all non-surgical and alternative treatments have been tried and there is moderate to severe chronic pain that has improved in response to diagnostic medial branch block.

Epidurals (local anaesthetic and steroid) should be considered in patients who have acute and severe lumbar radiculopathy at time of referral.

Alternative and less invasive options have been shown to work e.g. exercise programmes, behavioural therapy, and attending a specialised pain clinic. Alternative options are suggested in line with the National Back Pain Pathway.

Commissioning policy: Injections for non-specific low back pain without sciatica

Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of the CCG upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.

Referral Instructions

Queries and applications should be submitted by clinicians to the Individual Funding Request Panel via our generic email address: d-ccg.ifr-newsdt@nhs.net

Exceptional /Individual Funding Requests (IFR).

Referral Forms

Referral Form – Individual Funding Request (IFR)

Supporting Information

Patient Information

Individual Funding Request (IFR) Patient information leaflet

Date of publication: 8 March 2019

 

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