Chiropractic Treatment on the UK National Health Service (NHS) - It May Be Sooner Than You Think!


The long awaited report on how low back pain should best be treated in the UK was published recently by National Institute for health and Clinical Excellence (NICE). NICE for those who do not know is an independent group set up by the government to evaluate the available research on a particular condition. Its job is to publish clear guidelines for the best way to treat a particular condition in the UK National Health Service (NHS) hospitals or at Primary Care Trust (PCT) level i.e. Direct referral via you General Practitioner (GP/MD).

This new guide covers non specific back pain. This represents all the mechanical causes of lower back pain a Chiropractor typically sees. It includes pain coming from joints, discs, muscles, tendons and ligaments and according to Richard Nelson, a Chiropractor in Derby ”forms over 99% of the causes of lower back pain that a typical Chiropractor will see in every day practice”.

Specific back pain is where there is a non mechanical cause for your pain such as cancer, infection or fractures. Your chiropractor has under gone extensive medical training to able to distinguish between the two classifications so can decide which patients are suitable for Chiropractic treatment and those that are not. In a typical Chiropractic practice Specific back pain usually forms less than 1% of all cases.

NICE recommendations are:-

Any persistent or recurrent low back pain lasting more than 6 weeks and less than 12 months one of following three options should be offered taking in to account the patients (‘your’) preference.


  1. A course of manual therapy - up to 9 sessions over 12 weeks (manual therapy encompasses manipulation, mobilisation and massage).
  2. Acupuncture - up to 10 sessions over 12 weeks.
  3. Group physical exercise programme 8 sessions over 12 weeks.


NICE stated that manipulation can be performed by Chiropractors or Osteopaths. Chiropractors and Osteopaths are experts in manipulative techniques and along with mobilisation and massage they have been the core treatment methods of the two professions in the UK for over 100 years. It’s ironic now that research now ‘proves’ that the hands on approach that the professions have adopted for many years really does ‘work’. So NICE makes it clear that the Chiropractic and Osteopathic professions should be used for the provision of low back pain treatment in the general population under the NHS.

Doctors and Physiotherapists who have undergone specialist post graduate training in manipulation are also included as suitable providers of manipulation treatment. However, generally manipulation is not taught to Doctors or Physiotherapists as part of their standard training in the UK and so the majority of Doctors and Physiotherapists do not perform it.

NICE further recommends that if one chosen treatment does not result in satisfactory improvement another one of the 3 options should be offered to you.

What can you do? Next time you visit your GP you can ask;

As per NICE guidelines for low back pain will you (your GP) refer you for Chiropractic treatment for your low back pain in the NHS? If not, ask them why not? As this is what the NICE guidelines recommend for its treatment.

Richard Nelson comments:

Rome wasn’t built in a day! Don’t expect to be referred straight away. The more of you who ask and the more often you ask the sooner Chiropractic will be available to you and others on the NHS!

The author of this article is Ian Reed. He is a Chiropractor and has been in practice since 1992 - so he has a vast amount of experience treating all causes of non specific lower back pain. He is co founder of WellBeing Clinics, a Chiropractic Clinic in Derby, Derbyshire, UK. To read more other interesting articles by the author visit chiropractors derby website
Copyright Ian Reed

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This entry was posted on Tuesday, April 24th, 2012 at 1:42 pm and is filed under Chiropractic Treatment. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.


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