Quality statement 5: Opioids for chronic low back pain without sciatica

Quality statement

Young people and adults are not given opioids to treat chronic low back pain without sciatica.

Rationale

The use of opioids does not have a significant clinical benefit in the management of chronic low back pain without sciatica. It can therefore lead to unnecessary side effects for the person, risk of dependency and inappropriate use of resources.

Quality measures

Structure

Evidence of local arrangements to ensure that no GP prescriptions include opioids to treat young people and adults with chronic low back pain without sciatica unless they have other indications for those medicines.

Data source: Local data collection, for example, service protocols.

Process

Proportion of young people and adults who are given opioids to treat chronic low back pain without sciatica and have no other indications for them.

Numerator – the number in the denominator who are given opioids.

Denominator – the number of young people and adults with chronic low back pain without sciatica and no other indications for opioids.

Data source: Local data collection, for example, GP prescribing audits.

Outcome

Number of opioids-related adverse events for young people and adults with chronic low back pain without sciatica.

Data source: Local data collection, for example, GP prescribing audits.

What the quality statement means for different audiences

Service providers (such as GP practices) have systems in place to make staff aware that they should not give opioids to treat chronic low back pain without sciatica. Young people and adults should only be offered opioids when there are other indications for those medicines.

Healthcare professionals (such as GPs and nurses) do not give opioids to young people and adults to treat chronic low back pain without sciatica. They should only offer opioids when there are other indications for those medicines.

Commissioners (such as clinical commissioning groups and NHS England) ensure that they have agreed service specifications which state that services do not treat chronic low back pain without sciatica using opioids.

Young people and adults with low back pain without sciatica are not given opioids to treat their condition unless they need them for other conditions. This is because these medicines are not effective in either easing pain or restoring function such as walking and doing daily tasks.

Source guidance

Low back pain and sciatica in over 16s (2016) NICE guideline NG59, recommendation 1.2.23.

Definition of terms used in this quality statement

Chronic low back pain

Having symptoms for more than 3 months.

[Adapted from NICE's full guideline on low back pain and sciatica in over 16s]