The World Health Organization (WHO) has published new guidelines for the non-surgical management of chronic primary low back pain in adults in primary and community care settings. Although the guidelines are commendable, they lack guidance on when to suspect and how to avoid missing important secondary causes of back pain.
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References
World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. https://www.who.int/publications/i/item/9789240081789 (2023).
Qaseem, A. et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 166, 514–530 (2017).
Deodhar, A. et al. Frequency of axial spondyloarthritis diagnosis among patients seen by US rheumatologists for evaluation of chronic back pain. Arthritis Rheumatol. 68, 1669–1676 (2016).
Yi, E., Ahuja, A., Rajput, T., George, A. T. & Park, Y. Clinical, economic, and humanistic burden associated with delayed diagnosis of axial spondyloarthritis: a systematic review. Rheumatol. Ther. 7, 65–87 (2020).
Magrey, M. et al. Understanding barriers in the pathway to diagnosis of ankylosing spondylitis: results from a US survey of 1690 physicians from 10 specialties. ACR Open Rheumatol. 2, 616–626 (2020).
Mathieson, H. R., Merashli, M., Gaffney, K. & Marzo-Ortega, H., BritSpA (British Society for Spondyloarthritis). Poor awareness of inflammatory back pain and axial spondyloarthritis among secondary care specialists. Clin. Rheumatol. 35, 2627–2628 (2016).
Yong, C. Y. et al. Awareness of axial spondyloarthritis among chiropractors and osteopaths: findings from a UK Web-based survey. Rheumatol. Adv. Pract. 3, rkz034 (2019).
Ward, M. M. et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Care Res. 71, 1285–1299 (2019).
Deodhar, A., Kruzikas, D., Zhou, L., Biljan, A. & Saffore, C. D. Geographic variations in diagnosis and treatment of ankylosing spondylitis in the United States: a real-world study. Rheumatol. Ther. 9, 447–463 (2022).
Dubreuil, M. et al. Spondyloarthritis Research and Treatment Network (SPARTAN) draft referral recommendations for axial spondyloarthritis [abstract]. Arthritis Rheumatol. 75 (suppl. 9), https://acrabstracts.org/abstract/spondyloarthritis-research-and-treatment-network-spartan-draft-referral-recommendations-for-axial-spondyloarthritis/0 (2023).
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Bittar, M., Deodhar, A. A critical view of WHO guidelines on management of low back pain. Nat Rev Rheumatol 20, 201–202 (2024). https://doi.org/10.1038/s41584-024-01088-7
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DOI: https://doi.org/10.1038/s41584-024-01088-7
