WHO released its first-ever guidelines on managing chronic low back pain, listing interventions for health care personnel to use (and not use) in primary and community care settings.
According to WHO, low back pain is the leading cause of disability globally. In 2020, approximately 1 in 13 people experienced low back pain, a 60% increase from 1990. Cases are expected to rise to an estimated 843 million by 2050, with the greatest growth anticipated in Africa and Asia, where populations are getting larger and people are living longer.
In the new guidelines, WHO recommends nonsurgical interventions for low back pain, including
- education programs that support knowledge and self-care strategies
- exercise programs
- some physical therapies such as spinal manipulative therapy and massage
- psychological therapies such as cognitive behavioral therapy
- medicines such as nonsteroidal anti-inflammatory medicines
The guidelines also outline 14 interventions that are not recommended for most people in most contexts. They include
- lumbar braces, belts, and/or supports
- some physical therapies such as traction (i.e., pulling on part of the body)
- some medicines, such as opioid painkillers, which can be associated with overdose and dependence
Chronic low back pain refers to pain that lasts for more than 3 months that is not due to an underlying disease or other condition.
“Addressing chronic low back pain requires an integrated, person-centered approach. This means considering each person’s unique situation and the factors that might influence their pain experience,” said Anshu Banerjee, PhD, MPH, MD, WHO director for maternal, newborn, child, and adolescent health and ageing, in a press statement. “We are using this guideline as a tool to support a holistic approach to chronic low back pain care and to improve the quality, safety, and availability of care.”