1.Self management: the patients should know information about low back pain nature. They also should encourage to get back to their normal activity.
2.Manual therapy treatment package: Mobilization, manipulation, soft tissue techniques. Manual therapy techniques should be combined with exercise program.
3.Exercise program: the program should be tailored according patient needs and capabilities.
4.Psychological considerations: cognitive behavioural therapy is an effective treatment approach with patients who have constant low back pain due to psychological believes such as fear of movement or previous non effective treatment.
5.Pharmacological treatment: oral NSAIDs for low back pain at the lowest effective dose for the shortest possible period of time.
6.Radiofrequency denervation: Only perform radiofrequency denervation in people with Severe chronic low back pain after a positive response to a diagnostic medial branch block.
7.Surgical referral: according to patient needs, case severity after non-effective treatment. List of non-effective treatment approaches according to NICE guidelines:
6. Spinal injections All guidelines represent the view of NICE, published after careful consideration of the latest available evidence till July 2017.
Read more about NICE guidelines for musculoskeletal conditions: