Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview

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dc.creatorCrystian Bitencourt Soares de Oliveira
dc.creatorChristopher Gerard Maher
dc.creatorRafael Zambelli de Almeida Pinto
dc.creatorAdrian Traeger
dc.creatorChung-Wei Christine Lin
dc.creatorJean-François Chenot
dc.creatorMaurits van Tulder
dc.creatorBart Willem Koes
dc.date.accessioned2023-01-18T15:04:52Z
dc.date.accessioned2025-09-09T00:36:24Z
dc.date.available2023-01-18T15:04:52Z
dc.date.issued2018
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.description.sponsorshipOutra Agência
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1007/s00586-018-5673-2
dc.identifier.issn1432-0932
dc.identifier.urihttps://hdl.handle.net/1843/48979
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofEuropean Spine Journal
dc.rightsAcesso Aberto
dc.subjectDor lombar
dc.subjectDiagnóstico
dc.subjectTratamento
dc.subject.otherLow back pain
dc.subject.otherClinical guidelines
dc.subject.otherDiagnosis
dc.subject.otherTreatment
dc.titleClinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview
dc.typeArtigo de periódico
local.citation.epage2803
local.citation.issue11
local.citation.spage2791
local.citation.volume27
local.description.resumoObjective: The aim of this study was to provide an overview of the recommendations regarding the diagnosis and treatment contained in current clinical practice guidelines for patients with non-specific low back pain in primary care. We also aimed to examine how recommendations have changed since our last overview in 2010. Method: The searches for clinical practice guidelines were performed for the period from 2008 to 2017 in electronic databases. Guidelines including information regarding either the diagnosis or treatment of non-specific low back pain, and targeted at a multidisciplinary audience in the primary care setting, were considered eligible. We extracted data regarding recommendations for diagnosis and treatment, and methods for development of guidelines. Results: We identified 15 clinical practice guidelines for the management of low back pain in primary care. For diagnosis of patients with non-specific low back pain, the clinical practice guidelines recommend history taking and physical examination to identify red flags, neurological testing to identify radicular syndrome, use of imaging if serious pathology is suspected (but discourage routine use), and assessment of psychosocial factors. For treatment of patients with acute low back pain, the guidelines recommend reassurance on the favourable prognosis and advice on returning to normal activities, avoiding bed rest, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and weak opioids for short periods. For treatment of patients with chronic low back pain, the guidelines recommend the use of NSAIDs and antidepressants, exercise therapy, and psychosocial interventions. In addition, referral to a specialist is recommended in case of suspicion of specific pathologies or radiculopathy or if there is no improvement after 4 weeks. While there were a few discrepancies across the current clinical practice guidelines, a substantial proportion of recommendations was consistently endorsed. In the current review, we identified some differences compared to the previous overview regarding the recommendations for assessment of psychosocial factors, the use of some medications (e.g., paracetamol) as well as an increasing amount of information regarding the types of exercise, mode of delivery, acupuncture, herbal medicines, and invasive treatments.
local.identifier.orcidhttps://orcid.org/0000-0002-6911-7018
local.identifier.orcidhttps://orcid.org/0000-0002-1628-7857
local.identifier.orcidhttps://orcid.org/0000-0002-2775-860X
local.identifier.orcidhttps://orcid.org/0000-0002-1646-1907
local.identifier.orcidhttps://orcid.org/0000-0001-6192-7238
local.identifier.orcidhttps://orcid.org/0000-0001-8877-2950
local.identifier.orcidhttps://orcid.org/0000-0002-7589-8471
local.identifier.orcidhttps://orcid.org/0000-0002-0450-9969
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE FISIOTERAPIA
local.publisher.initialsUFMG
local.url.externahttps://link.springer.com/article/10.1007/s00586-018-5673-2#Abs1

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