WHO recommendations for back pain care

The Bulletin of the World Health Organisation (WHO) has recently pusblished an “Policy and Practice” article giving recommendations for back pain care, based on six of the major international clinical guidelines released since 2016. This report emphasizes the importance of adopting a stratified approach to care, and recommends the following care practices for different stages:

  1. Deliver advice to remain active, education and reassurance of patients in first step care.
  2. Physical and psychological therapies in second step care for acute pain, plus complementary therapies for stress reduction (mindfulness, yoga, Tai-Chi, etc.) for chronic pain.
  3. Multidisciplinary pain management involving teams of clinicians in third step care.

In all cases, care without medication is recommended. Whenever it is needed, it should begin with nonsteroidal anti-inflammatory drugs at the lowest effective dose for the shortest time, and opioids should be avoided.

Read the complete article: Care for low back pain: can health systems deliver?, by Adrian C Traeger, Rachelle Buchbinder, Adam G Elshaug, Peter R Croft & Chris G Maher.