The National Institute for Health and Clinical Excellence (NICE) published guidance on the treatment of non-specific low back pain in May 2009.  Recommendations in Low back pain: Early management of persistent non-specific low back pain, include manual therapy, as practised by osteopaths. This includes spinal manipulation, mobilisation and massage, for patients who “have been in pain for longer than six weeks but less than one year, where pain may be linked to structures in the back such as joints, muscles and ligaments”.