Guidelines overplayed support for telling patients LBP is benign with a good prognosis, telling patients to stay active, and telling patients to get back to work early. They underplayed support for advice on self-management of LBP, including strategies for managing and coping with pain, managing stress, and avoiding or minimizing pain with posture, ergonomics and sparing strategies.
On average, the guidelines were about eight years old, which could help explain the lack of concordance with the evidence, the authors note. “There may also be a bias towards simpler, more easily implemented components as guidelines overstated simple messages … and underplayed more involved self-management strategies,” they add.
The results show, they conclude, “that the potential clinical value of advice interventions for patients with acute LBP are probably not being realized.”
Dr. Stevens was not available for an interview by press time.
- Stevens ML, Lin CC, de Carvalho FA, et al. Advice for acute low back pain: A comparison of what research supports and what guidelines recommend. Spine J. 2017 Jul 13. pii: S1529-9430(17)30328-5. doi: 10.1016/j.spinee.2017.05.030. [Epub ahead of print]