Thousands of patients could undergo unnecessary spinal operations because of new NHS guidelines on treatments for lower back pain, warn experts.
Dozens of hospital consultants say the ‘cost- cutting’ restrictions mean more patients will end up having major surgery. They claim less risky procedures using spinal injections have been wrongly dismissed as ineffective, even though they help hundreds of thousands of patients with chronic back pain each year.
Guidelines issued earlier this week by the National Institute for Health and Clinical Excellence (NICE) set out permitted treatments for patients whose back pain has lasted for at least six weeks but less than a year. They endorsed widespread use of ‘alternative’ therapy, letting patients opt for a three-month course of acupuncture, manual therapy such as physiotherapy, or exercise.
Described as a ‘sea-change’ for back pain sufferers, the guidelines also told doctors not to recommend therapies with ‘little evidence’ to support them, controversially including injections of small amounts of steroids into the back, MRI scans, X-rays and ultrasound. Now, many patients who fail to respond to initial treatment could miss out this intermediate stage and proceed straight to risky spinal fusion operations.
NICE estimates the NHS will make annual savings of £33million on back injections and £11million on MRI scans. However, it will spend £24million extra on acupuncture and £16million extra on manual therapy, making the cost-cutting aspect negligible.
Around 50 specialists belonging to the Interventional Pain Medicine Group of the British Pain Society are writing to NICE, claiming it has dismissed good evidence about spinal injections, which do not cure pack pain but give a period of relief from chronic pain.