Treatment of Unspecific Back Pain in Children and Adolescents: Results of an Evidence-Based Interdisciplinary Guideline
Children (Basel, Switzerland) · 2022 · DACH
Source and licence
- Authors
- Michael Frosch, Stina Leinwather, Stefan Bielack et al.
- Title
- Treatment of Unspecific Back Pain in Children and Adolescents: Results of an Evidence-Based Interdisciplinary Guideline
- Journal
- Children, 2022
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC8947172
Licence statement of the original publication
Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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.
Open the original publication →Full text on Europe PMC
Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
3.1. Physical Therapy and Physical Activity
- Recommendation 1We recommend that active physical therapy be provided to children and adolescents with non-specific back pain.A, level of evidence 2, consensus 100%
- Recommendation 2We recommend that in physical therapy, children and adolescents with non-specific back pain should be instructed to perform home exercise and physical activity. Adherence should be regularly monitored and adjusted by physical therapists.A, expert consensus 100%
- Recommendation 3Regarding manual therapy, no specific recommendation for non-specific back pain in childhood and adolescence can be provided due to inconsistent evidence.0, level of evidence 2, consensus 100%
3.2. Psychotherapy
- Recommendation 4We endorse cognitive behavioral therapy (CBT) as the primary treatment for children and adolescents with recurrent or chronic non-specific back pain.B, level of evidence 2, consensus 100%
3.3. Drug Therapy
- Recommendation 5We advise against pharmacological treatment of recurrent or chronic non-specific back pain in children and adolescents.A, level of evidence 1–2, consensus 100%
3.4. Invasive Therapy
- Recommendation 6We advise against invasive treatment for recurrent or chronic non-specific back pain in children and adolescents.A, expert consensus 100%
3.5. Interdisciplinary Treatment Programs
- Recommendation 7We recommend that children and adolescents with recurrent and chronic non-specific back pain, severe pain-related disability, and ineffective unimodal treatment receive intensified interdisciplinary multimodal pain treatment.A, level of evidence 2, consensus 100%
Abstract
Using a structured approach and expert consensus, we developed an evidence-based guideline on the treatment and prevention of non-specific back pain in children and adolescents. A comprehensive and systematic literature search identified relevant guidelines and studies. Based on the findings of this literature search, recommendations on treatment and prevention were formulated and voted on by experts in a structured consensus-building process. Physical therapy (particularly physical activity) and psychotherapy (particularly cognitive behavioral therapy) are recommended for treating pediatric non-specific back pain. Intensive interdisciplinary treatment programs should be provided for chronic and severe pain. Drug therapy should not be applied in children and adolescents. Further research on non-specific back pain in childhood and adolescence is strongly needed to reduce the imbalance between the high burden of non-specific back pain in childhood and adolescence and the low research activity in this field.
Contents of the original publication
The section headings of the original.
- 1. Introduction
- 2. Materials and Methods
- 2.1. Constituting Meeting
- 2.2. Systematic Literature Search
- 2.3. Consensus Building
- 2.4. External Review
- 3. Results
- 3.1. Physical Therapy and Physical Activity
- 3.2. Psychotherapy
- 3.3. Drug Therapy
- 3.4. Invasive Therapy
- 3.5. Interdisciplinary Treatment Programs
- 3.6. Prevention
- 4. Discussion
- Supplementary Materials
- Institutional Review Board Statement
- Informed Consent Statement
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