I was intrigued to see a campaign launched in Wales to help with treatment of acute low back pain. Or perhaps the word should be management rather than treatment as they don't seem to mention any treatment for folks who have acute low back pain at all. Quite correctly they (and they are "a joint initiative developed in response to Health Challenge Wales") point out that the medicalisation of back pain is a bad thing and therefore "treatment' can be unhelpful in the resolution of the back pain symptoms. 

Quite correctly they talk about keeping active, keeping positive and understanding that pain does not equal damage. There is even a section on better breathing. There is some helpful advice for both patients and GPs alike about the likely outcomes and what is useful in terms of diagnosis.

The glaring omission from this worthy initiative is that there is a place for manual therapy and spinal manipulation in the management of acute back pain. People with back pain need advice and some demystification of the problems associated with back pain sure enough but many of them would also benefit from manipulation or acupuncture/dry needling. The only mention of spinal manipulation  is in a short piece by Jonathan Pryce, the actor, who says that he seeks the care of a qualified chiropractor when he has pain. Sensible chap.

The NICE guidelines for nonspecific back pain mention keeping active, manual therapy and acupuncture. I would have thought that the website ought at least give a  little advice about how to seek help and who from and what to expect.

I hope the good folk of Wales are happy doing breathing exercises when their backs are killing them. I, for one, would rather see my local quack.