WHO releases chronic low back pain guidelines  

Date:  December 22, 2023


Earlier this month, the World Health Organization (WHO) released its first-ever guidelines on chronic low back pain (CLBP), based on chiropractor-led input and research helmed by the Canadian Chiropractic Guidelines Initiative (CCGI). 

Low back pain is a global health concern and is the leading cause of disability globally across all ages and in both sexes.  

In 2020, approximately one in 13 people globally experienced low back pain (LBP).The WHO guidelines for non-surgical management of chronic primary low back pain in adults in primary and community care settings will provide evidence-based recommendations on nonsurgical interventions for chronic primary LBP (CPLBP) in adults, including older people, that can be delivered in primary and community care settings to improve CPLBP-related health and well-being outcomes.  

The Canadian Chiropractic Association (CCA) congratulates its partners the CCGI and CCA members Dr. Pierre Côté and Dr. Geoffrey Outerbridge. The CCGI team led four systematic reviews and noted, “It’s an opportune time for chiropractors to collaborate with primary care clinicians and policymakers!” The CCA supports and applauds the valuable resources made available in the guidelines and acknowledges the extensive research undertaken in its development. 

The guidelines will be of use to clinical staff including medical doctors, nurses, allied health workers including chiropractors, occupational therapists, physiotherapists, pharmacists, psychologists and community health workers, as well as public health programme and system managers. 

With the guidelines, the WHO recommends non-surgical interventions to help people experiencing chronic primary LBP. These interventions include: 

  • education programs that support knowledge and self-care strategies; 
  • exercise programs; 
  • some physical therapies, such as spinal manipulative therapy and massage; 
  • psychological therapies, such as cognitive behavioural therapy; and 
  • medicines, such as non-steroidal anti-inflammatory medicines. 

The guidelines were critical of the use of pharmacological interventions such as opioid painkillers, “which can be associated with overdose and dependence.”  

In a statement shared on the WHO website, Dr. Anshu Banerjee, WHO Director for Maternal, Newborn, Child, Adolescent Health and Ageing states, “We are using this guideline as a tool to support a holistic approach to chronic low back pain care and to improve the quality, safety and availability of care.” 

To access the guideline and additional executive summary, please visit the WHO here.  

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