The Library
Prevention and treatment of low back pain : evidence, challenges, and promising directions
Tools
Lancet Low Back Pain Series Working Group (Including: Foster, Nadine E., Anema, Johannes R., Cherkin, Dan, Chou, Roger, Cohen, Steven P., Gross, Douglas P., Ferreira, Paulo H., Fritz, Julie M., Koes, Bart W., Peul, Wilco, Turner, Judith A. and Maher, Chris G.). (2018) Prevention and treatment of low back pain : evidence, challenges, and promising directions. Lancet . doi:10.1016/S0140-6736(18)30489-6 ISSN 0140-6736.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: https://doi.org/10.1016/S0140-6736(18)30489-6
Abstract
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 with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. 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. The advances with the greatest potential are arguably those that align practice with the evidence, reduce the focus on spinal abnormalities, and ensure promotion of activity and function, including work participation. We have identified effective, 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.
Item Type: | Journal Article | ||||||
---|---|---|---|---|---|---|---|
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Journal or Publication Title: | Lancet | ||||||
Publisher: | The Lancet Publishing Group | ||||||
ISSN: | 0140-6736 | ||||||
Official Date: | 21 March 2018 | ||||||
Dates: |
|
||||||
DOI: | 10.1016/S0140-6736(18)30489-6 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Contributors: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |