Journal
LANCET
Volume 389, Issue 10070, Pages 736-747Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(16)30970-9
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Funding
- Australia (NHMRC)
- Brazil (FAPESP)
- Netherlands (ZonMW)
- Australia's National Health and Medical Research Council
- Australian Research Council
- Arthritis Australia
- NSW WorkCover
- NHMRC
- GlaxoSmithKline
- UK National Institute for Health Research
- HTA Project [11/31/01]
- ARC
- ZonMW in the Netherlands
- PCORI in the USA
- National Institute for Health Research [NF-SI-0616-10043, NF-SI-0512-10103] Funding Source: researchfish
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Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.
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