This article is more than 5 years old. Information may no longer be current.
NASS releases guidelines for diagnosis, treatment of low back pain
The North American Spine Society announced the release of evidence-based clinical guidelines for multidisciplinary spine care for the diagnosis and treatment of low back pain.
The guidelines can help practitioners treat adult patients with non-specific low back pain above the knee, according to a press release issued by the North American Spine Society.
“This is the largest clinical guideline NASS has ever undertaken,” D. Scott Kreiner, MD, an Arizona physiatrist, co-chair of NASS’ Evidence-Based Guideline Development Committee, and NASS Research Council Director, said in the release.
Eleven societies that offered stakeholder representatives to help develop the document and comment during its review. The Diagnosis and Treatment of Low Back Pain guideline document included over 45,000 literature search results and 82 clinical questions with more than 100 recommendation statements.
The recommendations address clinical questions on the diagnosis and treatment of adult patients with non-specific low back pain with leg pain above the knee, according to the release. The guideline was divided into sections that include diagnosis, imaging, medical and physiological treatment, physical medicine and rehabilitation, interventional treatment, surgical treatment and cost utility. A work group graded each guideline recommendation based on the strength of the scientific evidence.
“It’s important to understand the inclusion and exclusion criteria for this guideline in order to correctly interpret the recommendations,” Paul Matz, MD, a Wyoming-based neurosurgeon and co-chair of the Evidence-Based Guideline Development Committee, said in the release. “This guideline is focused on a subset of low back pain care as opposed to low back pain in its entirety.”
He added, “The guideline clearly describes the scope, patient population, development methodology, and levels of evidence used.”
Reference:
www.spine.org/Research-Clinical-Care/Quality-Improvement/Clinical-Guidelines
Perspective
Back to Top
The latest NASS evidence-based clinical guidelines for multidisciplinary spine care arrive at an optimal time. We are faced with an unprecedented worldwide burden of low back pain in an era marked by an increasing number of purported solutions to this pandemic. With a worldwide incidence of low back pain up to 69%, the NASS recommendations now provide us with many “grade A” recommendations. An “A” grade recommendation now supports treatments for low back pain such as combined cognitive-behavioral therapy (CBT) with physical therapy approaches, and also discourage the treatment of low back pain with SSRIs. Although these recommendations are certain to be extremely helpful for practitioners for years to come, the Spine literature remains underpowered, particularly regarding cost utility. Questions regarding who the most cost-effective providers are to address low back pain have been largely left unaddressed by our community. We have numerous research questions that either have conflicting – or an altogether absence of – evidence. While these questions are challenging, when prioritizing our patients, we must place this global morbidity at the forefront of our scientific inquiry.
Rush University Medical Center
Read more about