Other treatment options for simple low back pain of more than 6 weeks duration

Non-invasive treatments for low back pain

• self-management
  
• 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
  
• promote and facilitate return to work or normal activities of daily living for people with low back pain with or without sciatica

Invasive treatments for low back pain

• radiofrequency denervation
  • consider referral for assessment for radiofrequency denervation for people with chronic (3-month duration or longer) low back pain when:
    • non-surgical treatment has not worked for them and
    • the main source of pain is thought to come from structures supplied by the medial branch nerve and
    • they have moderate or severe levels of localised back pain (rated as 5 or more on a visual analogue scale, or equivalent) at the time of referral
  • only perform radiofrequency denervation in people with chronic low back pain after a positive response to a diagnostic medial branch block
  • do not offer imaging for people with low back pain with specific facet join pain as a prerequisite for radiofrequency denervation
• do not offer spinal fusion for people with low back pain unless as part of a randomised controlled trial
• do not offer spinal injections for managing low back pain

Reference:

• 1. NICE (July 2026).Low back pain - Early management of persistent non-specific low back pain