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Individual research recommendation details

Recommendation details

Recommendation ID: CG88/1
Question: Use of sequential therapies:- What is the effectiveness and cost effectiveness of sequential therapies (manual therapy, exercise and acupuncture) compared with single interventions with respect to pain, functional disability and psychological distress in people with persistent non-specific low back pain?
Page: 17
Any explanatory
notes (if applicable):
Why this is important:- There is evidence that manual therapy, exercise and acupuncture individually are cost-effective management options compared with usual care for persistent non-specific low back pain. The cost implications of treating people who do not respond to initial therapy and so receive multiple back care interventions are substantial. It is unclear whether there is added health gain for this subgroup from either multiple or sequential use of therapies. Research should: ? test the effect of providing a subsequent course of a different therapy (manual therapy, exercise or acupuncture) in the management of persistent non-specific low back pain, when the first-choice therapy has been inadequately effective. ? determine the cost effectiveness of providing more than one of these interventions to people with persistent non-specific low back pain.

Source guidance details

Comes from guidance: Low back pain
Number: CG88
Date issued: May 2009

Research needed into:

Effectiveness of treatment: No
Cost of treatment: No
Implementation of treatment: No
Quality of life: No
Methods of research: No

Other details

Is this a recommendation for the use of a technology only in the context of research?: No
Is it a recommendation that suggests collection of data or the establishment of a register?: No
Recommendation priority: Unrated
Recommendation status: Research Pending
Notes: Headings integrated into text
Date this record updated: 30-04-2010

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This page was last updated: 20 March 2014

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.