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Comparative Study
. 2024 May 1;25(1):344.
doi: 10.1186/s12891-024-07468-0.

Recent clinical practice guidelines for the management of low back pain: a global comparison

Tianyu Zhou  1 , David Salman  2   3 , Alison H McGregor  2
Affiliations
Comparative Study

Recent clinical practice guidelines for the management of low back pain: a global comparison

Tianyu Zhou et al. BMC Musculoskelet Disord. .

Abstract

Background: Low back pain (LBP) is a significant health problem worldwide, with a lifetime prevalence of 84% in the general adult population. To rationalise the management of LBP, clinical practice guidelines (CPGs) have been issued in various countries around the world. This study aims to identify and compare the recommendations of recent CPGs for the management of LBP across the world.

Methods: MEDLINE, EMBASE, CINAHL, PEDro, and major guideline databases were searched from 2017 to 2022 to identify CPGs. CPGs focusing on information regarding the management and/or treatment of non-specific LBP were considered eligible. The quality of included guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.

Results: Our analysis identified a total of 22 CPGs that met the inclusion criteria, and were of middle and high methodological quality as assessed by the AGREE II tool. The guidelines exhibited heterogeneity in their recommendations, particularly in the approach to different stages of LBP. For acute LBP, the guidelines recommended the use of non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic exercise, staying active, and spinal manipulation. For subacute LBP, the guidelines recommended the use of NSAIDs, therapeutic exercise, staying active, and spinal manipulation. For chronic LBP, the guidelines recommended therapeutic exercise, the use of NSAIDs, spinal manipulation, and acupuncture.

Conclusions: Current CPGs provide recommendations for almost all major aspects of the management of LBP, but there is marked heterogeneity between them. Some recommendations lack clarity and overlap with other treatments within the guidelines.

Keywords: Clinical practice guidelines; Low back pain; Management; Review; Treatment.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of guideline selection process
Fig. 2
Fig. 2
The commonality of therapeutic recommendations for patients with acute LBP
Fig. 3
Fig. 3
The commonality of therapeutic recommendations for patients with subacute LBP
Fig. 4
Fig. 4
The commonality of therapeutic recommendations for patients with chronic LBP
Fig. 5
Fig. 5
The commonality of therapeutic recommendations for patients with unspecified duration LBP
Fig. 6
Fig. 6
Mind map of self-management and its components. The different colour codes represent a hierarchical classification of interventions (yellow > green > blue). The dotted lines represent the possible overlap between the two interventions
See this image and copyright information in PMC

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