Much has been made of the latest NICE Guidelines for Treatment of Low Back Pain, particularly in the massage and osteopathy fields. The full guidelines can be found here but to summarise:

The 4 Principles of Management for all Patients are described as:

1. Keep diagnosis under review at all times
2. Promote self-management/advice
3. Offer drug treatments as appropriate
4. Offer a range of alternative treatments including exercise, acupuncture and manual therapy.

Manual therapy is then further identified:

The manual therapies reviewed were spinal manipulation, spinal mobilisation and massage. Collectively these are all manual therapy. Mobilisation and massage are performed by a wide variety of practitioners. Manipulation can be performed by chiropractors and osteopaths, as well as by doctors and physiotherapists who have undergone specialist postgraduate training in manipulation.

So that’s pretty conclusive, patients suffering from low back pain can and should be referred for massage and osteopathy, amongst other treatments. The guidleines recommend up to 9 treatments over up to 12 weeks.

This has got to be good news for both fields of treatment, hasn’t it? The question is, how are we practitioners going to make our presence felt? Should the GPs be actively looking for us or should we target them? And how responsive will GPs be to sending patients off for manual therapy as opposed to physiotherapy or drug treatment?

What do you all think?