Guidelines - Low Back Pain

Scope and Purpose of Guideline

 

Objective: This guideline covers the initial assessment, management, and monitoring of acute and chronic low back pain (LBP) in adults.

Target population: 

  • Adults with low back pain

Title of Guideline: Spinal manipulative therapy and other conservative treatments for low back pain (LBP) in adults

Author(s): ​Bussières A. et al.

Year of Publication: ​2018

Link for Full Guideline: link

Key Recommendations

 

Educate on the nature and course of low back pain, provide reassurance and advise on physical activity and self-management strategies. Based on patient and practitioner preference, we suggest: ​

Acute low back pain (0-3 months duration):

  • We suggest SMT, other commonly used treatments, or a combination of SMT and commonly used treatments to decrease pain and disability in the short term, based on patient preference and practitioner experience.

    • Other commonly used treatments may include advice on posture and physical activity, as usual, medical care when deemed beneficial.​

Chronic low back pain (>3 months duration):

  • We suggest SMT over minimal intervention to decrease pain and disability in the short term.

    • Minimal intervention includes manually applied forces with diminished magnitude or 5-minute light massage​

  • We recommend SMT or other treatments for short-term reduction in pain and disability.

    • Other treatments include extension exercises, advice plus exercise, myofascial therapy, usual medical care when beneficial. Pain relief is most effective within the first 6 months and functional improvement was more effective at 1 month.​

  • We suggest multimodal therapy with or without SMT to decrease pain and disability.

    • Multimodal therapy with SMT treatment may also include exercise, myofascial therapy, advice, educational material, usual medical care when deemed beneficial.​

    • SMT (2 sessions per week for 4 weeks) plus usual medical care has shown better pain and functional outcomes than usual medical are alone.

    • Pain and functional improvement was also shown at 3 and 12 months.

Chronic back-related leg pain (sciatica or radicular LBP):

  • We suggest SMT plus home exercise and advice to reduce back pain and disability. 

    • Reduced chronic back-related leg pain (sciatica or radicular low back pain) and disability were observed at 12 weeks follow-up. ​

    • Home exercise includes positioning and stabilization exercises.

  • Facebook Social Icon
  • Twitter Social Icon
  • YouTube Social  Icon
  • LinkedIn Social Icon

CCGI is funded by provincial associations and regulatory boards, and national associations including the Canadian Chiropractic Association

and Canadian Chiropractic Protective Association. CCGI maintains editorial independence from funders.

OnTEchU logo_transparent.png