Low Back Pain Guidelines

Low Back Pain Guidelines; when do we adopt a proactive and preventative care for Low Back Pain?

In these two links we explore Low Back Pain guidelines. In these papers, Australian researchers have cited the following factors that see low back pain continue to affect our health in our lifetime.

  • Ageing world population
  • Sedentary lifestyle
  • Reducing access to quality health care resources
  • Heavy reliance on surgical and medication prescription

Addressing these issues seem like intelligent reason to review low back pain and adopt a proactive, preventative guideline to care for this health care issue.

Paper 1:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30725-6/fulltext

Conclusion:

“Low back pain is a major problem throughout the world and it is getting worse—largely because of the ageing and increasing world population.1 It affects all age groups and is generally associated with sedentary occupations, smoking, obesity, and low socioeconomic status.2 Years lived with disability caused by low back pain have increased by more than 50% since 1990, especially in low-income and middle-income countries (LMICs).1,2 Disability related to low back pain is projected to increase most in LMICs where resources are limited, access to quality health care is generally poor, and lifestyle changes and shifts towards more sedentary work for some mean the risks will only increase.”

Paper 2:

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)30489-6.pdf

“Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include:

  • Use of a biopsychosocial framework to guide management
  • Initial non-pharmacological treatment
  • Including education that supports self-management
  • Resumption of normal activities and exercise
  • psychological programmes for those with persistent symptoms.

Recommendations promote prudent use of:

  • medication
  • imaging
  • surgery

The advances with the greatest potential are arguably those that:

  • align practice with the evidence
  • reduce the focus on spinal abnormalities
  • ensure promotion of activity and function, including work participation.

Further promising, or emerging solutions that could offer new directions, but that need greater attention and further research to determine if they are appropriate for large-scale implementation. These potential solutions include:

  •  focused strategies to implement best practice
  • the redesign of clinical pathways
  • integrated health and occupational interventions to reduce work disability
  • changes in compensation and disability claims policies, and public health and prevention strategies.

NOTE : The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences.”

 

Waterloo Chiropractic and Sports Massage believe in the merit of these guidelines and adopt the literature to enhance the outcomes for our patients.

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