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National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy

European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority.

Methods

Two multidisciplinary working groups formulated recommendations based on the GRADE approach.

Results

Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active. If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.

Conclusion

Recommendations are based on low to moderate quality evidence or on consensus, but are well aligned with recommendations from international guidelines. The guideline working groups recommend that research efforts in relation to all aspects of management of LBP and LR be intensified.

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Acknowledgements

We would like to acknowledge the contributions of Kirsten Birkefoss, Marina T. Axelsen, and Hanne Caspersen, research librarians at the Danish Health Authority; Christine Marie Bækø Halling, project manager at the Danish Health Authority; Helle Ulrichsen, chairman of the LBP working group, and Karsten Junker, chairman of LR working group.

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Correspondence to Mette Jensen Stochkendahl.

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Funding was provided by The Danish Finance Act (2012), and the DHA was commissioned to formulate the national clinical guidelines. Funding was provided to members of the project groups, i.e. lead reviewers (MJS and PK), project manager (BH), methodologists (JA and ST), search specialists, and chairmen. No funding was provided to the working or reference group members. The funders had no role in the design, collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Potential conflicts of interest have been declared by all involved partners and made publicly available on the DHA webpage (in Danish) [10, 11].

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Stochkendahl, M.J., Kjaer, P., Hartvigsen, J. et al. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J 27, 60–75 (2018). https://doi.org/10.1007/s00586-017-5099-2

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  • DOI: https://doi.org/10.1007/s00586-017-5099-2

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