On the 7th December 2023, the World Health Organisation (WHO) released its guideline for the non-surgical management of chronic primary low back pain in adults in primary and community care settings.
They define chronic lower back pain as symptoms, with or without spine related leg pain, for more than 3 months. There is an approved process for studies to be evaluated, although reading through the guidance there are some categories with very minimal volume of patients in the studies.
I have tried to superimpose other older guidance over the WHO guidance including
- NICE NG59 (2020) – Low back pain and sciatica in over 16s: assessment and management
- NICE NG193 (2021) – Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain
- BMJ Best Practice Musculoskeletal lower back pain (updated Oct 2023) – specifically management of chronic lower back pain
There appears a degree of consistency for some areas of treatment of chronic lower back pain, but as expected there are a few differences.
Key points from this extensive document (with comments from the above guidance) are documented.