Question

A 46-year-old woman presents to her GP with chronic low back pain for 8 months without radicular symptoms. Examination is normal and there are no red-flag features such as weight loss, systemic symptoms or neurological deficits. According to NICE guidance, what is the most appropriate management

Accepted Answer

Recommend exercise therapy and consider manual therapy as part of a package

Answer

Offer a course of spinal manipulation with no exercise

Answer

Arrange an urgent MRI of the lumbar spine

Answer

Prescribe long-term strong opioids for pain control

Answer

Refer immediately for spinal surgery

Practice question

A 46-year-old woman presents to her GP with chronic low back pain for 8 months without radicular symptoms. Examination is normal and there are no red-flag features such as weight loss, systemic symptoms or neurological deficits. According to NICE guidance, what is the most appropriate management