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

BMC Musculoskeletal Disorders · 2024 · Europe

Source and licence

Authors
Tianyu Zhou, David Salman, Alison. H. McGregor
Title
Recent clinical practice guidelines for the management of low back pain: a global comparison
Journal
BMC Musculoskeletal Disorders, 2024
DOI
10.1186/s12891-024-07468-0
Licence
CC BY 4.0
Changes
Verbatim excerpts; formatting adapted

Full text retrieved 2026-10-27 from Europe PMC · PMC11061926

Licence statement of the original publication

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.

This is a review of another guideline (Recent clinical practice guidelines for low back pain (global comparison), international (NICE, ACP, national bodies) 2024). We do not reproduce that guideline's recommendations here – they belong to the original guideline.

Open the original publication →Full text on Europe PMC

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.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12891-024-07468-0.

Contents of the original publication

The section headings of the original.

  • Introduction
  • Methods
  • Search strategy
  • Eligibility criteria
  • Study selection
  • Quality assessment
  • Data extraction
  • Data synthesis
  • Results
  • Selection of guidelines
  • Guideline characteristics
  • Quality assessment of included guideline
  • Treatment recommendations
  • Acute LBP
  • Subacute LBP
  • Chronic LBP
  • Unspecified duration of LBP
  • Discussion
  • Summary of key findings
  • The differences in the duration of symptoms
  • Quality assessment of CPGs using the AGREE II tool
  • Discrepancies in the recommendation across the guidelines
  • Overlap in the current guidelines
  • Multidisciplinary biopsychosocial intervention
  • Implications
  • Limitations
  • Conclusion

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