Low back pain and sciatica in over 16s: assessment and management

Recommendation ID: NG59/2
Question: Pharmacological therapies:- What is the clinical and cost effectiveness of codeine with and without paracetamol for the acute management of low back pain?
Any explanatory notes (if applicable): Why this is important:- Codeine, often together with paracetamol, is commonly prescribed in primary care to people presenting with acute low back pain. This often happens with people who cannot tolerate nonsteroidal anti-inflammatory drugs (NSAIDs) or when a person has contraindications to these medications. Although there is evidence that opioids are not effective in chronic low back pain, there are relatively few studies that look at their use for acute low back pain (a problem commonly seen in primary care). Also, it is not known if using paracetamol and codeine together has a synergistic effect in the treatment of back pain.

Source guidance details

Comes from guidance: Low back pain and sciatica in over 16s: assessment and management
Number: NG59
Date issued: November 2016

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
Last Reviewed	30/11/2016