Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines

Simon Dagenais, DC, PhD

Palladian Health
West Seneca, NY
Department of Social and Preventive Medicine
University at Buffalo
Buffalo, NY

Common and costly, low back pain can be challenging to manage. Clinical practice guidelines on LBP recommend preferred treatment strategies based on reviews of published evidence. The quality and content of various recommendations, however, may vary, and compliance with clinical practice guidelines has remained low. Here, Dr Dagenais discusses a systematic review and synthesis of recent clinical practice guidelines for assessing and managing LBP. Guideline methodologies were compared and rated. The review revealed marked agreement among the 10 eligible clinical practice guidelines, including benefits of patient education, “red flags” for serious underlying conditions, and the self-limiting nature of LBP for most patients. Suggestions for developing future clinical practice guidelines for LBP are also discussed. Implementing evidence-based recommendations in the clinic will likely reduce costs and improve outcomes for patients with LBP.

References

Dagenais S, Tricco AC, Haldeman S. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Spine J. 2010;10:514-529.
Becker A, Leonhardt C, Kochen MM, et al. Effects of two guideline implementation strategies on patient outcomes in primary care: a cluster randomized controlled trial. Spine. 2008;33:473-480.
Webster BS, Courtney TK, Huang YH, et al. Physicians’ initial management of acute low back pain versus evidence-based guidelines. Influence of sciatica. J Gen Intern Med. 2005;20:1132–5.
Jackson JL, Browning R. Impact of national low back pain guidelines on clinical practice. South Med J. 2005;98:139-143.

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