Back pain is common and is usually a normal life experience!

Last month there was self-care week and lots of messages across social media in our Region about how people can self-care. Recent national news coverage pointed to new back pain as one of those problems http://www.bbc.co.uk/news/health-37871180 . People often want to see their GP as quickly as possible but there are simple things that patients can do to help themselves.

Messages like keeping active and adopting a healthy lifestyle sound basic but the research shows this approach is key for people hoping to improve back pain when it is a new episode.   The National Institute for Clinical Excellence evidence-based recommendations published this week https://www.nice.org.uk/guidance/NG59 confirms this approach and it is the main message that patients attending practices in the NHS North Durham CCG area will receive from this week.

The CCG is launching the pathway from the beginning of December for all patients asking to see their GP about back pain. This is part of the Regional Back Pain Programme in the North East and Cumbria. GPs and local health professionals will all be giving the same advice, based on the Golden Rules  from the programme. The programme’s website and animation explain that the best way of approaching new episodes of back pain is to self-care www.NoEBackpainProgramme.nhs.ukgoldenrulesscroll

In South Tees, Hartlepool and Stockton-on-Tees, Darlington and Hambleton, Richmondshire and Whitby, GPs have been using the new programme to advise patients about the best approach to treat and manage new episodes of back pain. Other areas will be rolling out the approach shortly. This will add to a growing number of people in the country aware that new back pain is common, that 80% of us will experience back pain at some point in our lives and new back problems normally improve significantly within the first 2 weeks with a lot of episodes almost completely better by 6 weeks. Treatment and investigations are rarely necessary in those first 6 weeks.

The Regional Back Pain programme aims to make sure that all staff and patients recognise this. Under the programme all patients with back pain get the same advice and treatment whichever health professional they see, including what they can do about new problems and when they should seek professional help if things don’t improve when they would normally be expected to.

Dr Andrea Jones, Chair, NHS Darlington Clinical Commissioning Group (CCG) and clinical lead for the programme said, “This programme aims to dismantle many of the myths around back pain and ensure that we only treat people when the medical evidence tells us it is worthwhile to do so. It is part of a growing movement to explain that it is common and normal, many of us will suffer from it and most of us WILL recover naturally in time.”

“Scans, x-rays, injections and surgery are rarely needed and one of the things that research shows to be most beneficial is to keep moving during the day as much as possible, if necessary with the help of painkillers and to then get a good night’s sleep. If you have suffered from back pain, you will know it can be excruciating. I do not doubt that it is a challenge for GPs to simply encourage patients to consider how to help themselves without necessarily referring for investigation or physiotherapy in the early stages, but the evidence is clear that keeping moving even if slowly at first and taking simple painkillers available from your local pharmacy are important first steps.”

Dr Neil O’Brien, Clinical Chief Officer, NHS North Durham CCG said, “Everyone has been working hard to make sure that the programme works effectively in our area. It is essential that the right, consistent, messages are given by healthcare professionals across the various NHS services. We want to make sure that patients are given the right advice and support at the very start of their treatment in order to ensure that they have the best outcome and can manage their pain effectively.”

The North of England Back Pain Programme is currently in its 2nd phase in the North East and Cumbria. The 3rd Phase will commence shortly. The team are studying what happens to patients with this consistent approach and the work is being evaluated by Teesside University. The programme is funded by the Health Foundation, an independent charity, as part of the ‘Scaling Up Improvement Programme. It follows the initial early roll-out of the approach as Phase 1 in the South Tees area, funded by the North East and North Cumbria Academic Health Science Network.