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

BMC musculoskeletal disorders
January 1, 1970
Tianyu Zhou et al. (3 authors)
Journal ArticleComparative StudyHuman Study
Study Details

Study Goal

The researchers aimed to compare clinical practice guidelines (CPGs) for managing low back pain (LBP) globally, including the role of acupuncture in chronic LBP treatment.

Results Summary

The study found that acupuncture was recommended in CPGs for chronic LBP, alongside therapeutic exercise, NSAIDs, and spinal manipulation, though guidelines exhibited heterogeneity in recommendations.

Population

Adults with non-specific low back pain (acute, subacute, and chronic stages).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
non-steroidal anti-inflammatory drugs (NSAIDs)
no change
acute low back pain
patients with low back pain
-
recommended
#1
therapeutic exercise
no change
acute low back pain
patients with low back pain
-
recommended
#2
staying active
no change
acute low back pain
patients with low back pain
-
recommended
#3
spinal manipulation
no change
acute low back pain
patients with low back pain
-
recommended
#4
non-steroidal anti-inflammatory drugs (NSAIDs)
no change
subacute low back pain
patients with low back pain
-
recommended
#5
therapeutic exercise
no change
subacute low back pain
patients with low back pain
-
recommended
#6
staying active
no change
subacute low back pain
patients with low back pain
-
recommended
#7
spinal manipulation
no change
subacute low back pain
patients with low back pain
-
recommended
#8
therapeutic exercise
no change
chronic low back pain
patients with low back pain
-
recommended
#9
non-steroidal anti-inflammatory drugs (NSAIDs)
no change
chronic low back pain
patients with low back pain
-
recommended
#10
spinal manipulation
no change
chronic low back pain
patients with low back pain
-
recommended
#11
acupuncture
no change
chronic low back pain
patients with low back pain
-
recommended
#12
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.

Medical Subject Headings (MeSH)
Low Back PainHumansPractice Guidelines as TopicAnti-Inflammatory Agents, Non-SteroidalExercise TherapyManipulation, SpinalChronic PainPain Management
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations29
Citations/Year29.0
Relative Citation Ratio14.55
Research Impact Scores
APT Score0.95
Weight Score1.86
Normalized Score0.67
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