European Spine Journal

, Volume 27, Issue 1, pp 60–75 | Cite as

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

  • Mette Jensen Stochkendahl
  • Per Kjaer
  • Jan Hartvigsen
  • Alice Kongsted
  • Jens Aaboe
  • Margrethe Andersen
  • Mikkel Ø. Andersen
  • Gilles Fournier
  • Betina Højgaard
  • Martin Bach Jensen
  • Lone Donbæk Jensen
  • Ture Karbo
  • Lilli Kirkeskov
  • Martin Melbye
  • Lone Morsel-Carlsen
  • Jan Nordsteen
  • Thorvaldur Skuli Palsson
  • Zoreh Rasti
  • Peter Frost Silbye
  • Morten Zebitz Steiness
  • Simon Tarp
  • Morten Vaagholt
Review Article



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.


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


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.


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.


Clinical guideline Low back pain Lumbar radiculopathy Non-surgical intervention Recommendations Conservative treatment 



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.

Compliance with ethical standards


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.

Conflicts of interest

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

Supplementary material

586_2017_5099_MOESM1_ESM.pdf (7.9 mb)
Supplementary material 1 (PDF 8135 kb)
586_2017_5099_MOESM2_ESM.pdf (5.5 mb)
Supplementary material 2 (PDF 5658 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Mette Jensen Stochkendahl
    • 1
    • 2
    • 3
  • Per Kjaer
    • 1
    • 3
  • Jan Hartvigsen
    • 1
    • 2
  • Alice Kongsted
    • 1
    • 2
  • Jens Aaboe
    • 3
  • Margrethe Andersen
    • 4
  • Mikkel Ø. Andersen
    • 5
  • Gilles Fournier
    • 6
  • Betina Højgaard
    • 3
    • 7
  • Martin Bach Jensen
    • 8
  • Lone Donbæk Jensen
    • 9
  • Ture Karbo
    • 10
  • Lilli Kirkeskov
    • 11
  • Martin Melbye
    • 12
  • Lone Morsel-Carlsen
    • 13
    • 14
  • Jan Nordsteen
    • 15
  • Thorvaldur Skuli Palsson
    • 16
  • Zoreh Rasti
    • 13
  • Peter Frost Silbye
    • 17
  • Morten Zebitz Steiness
    • 18
  • Simon Tarp
    • 3
    • 19
  • Morten Vaagholt
    • 20
  1. 1.Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdense MDenmark
  2. 2.Nordic Institute of Chiropractic and Clinical BiomechanicsUniversity of Southern DenmarkOdense MDenmark
  3. 3.The Danish Health AuthorityCopenhagen SDenmark
  4. 4.Frederiksberg MunicipalityFrederiksbergDenmark
  5. 5.Center for Spine Surgery and Research, Lillebaelt HospitalMiddelfartDenmark
  6. 6.Center for Rheumatology and Spine Diseases, Frederiksberg HospitalFrederiksbergDenmark
  7. 7.KORA-the Danish Institute for Local and Regional Government ResearchCopenhagen KDenmark
  8. 8.Research Unit for General Practice, Department of Clinical MedicineAalborg UniversityAalborg ODenmark
  9. 9.Department of Occupational Medicine, Danish Ramazzini CenterAarhus University HospitalAarhus CDenmark
  10. 10.Spine Unit, Department of Orthopaedic SurgeryThe National University HospitalCopenhagenDenmark
  11. 11.Unit of Social Medicine, Department of Occupational and Environmental MedicineFrederiksberg HospitalFrederiksbergDenmark
  12. 12.Aalborg Spine ClinicAalborgDenmark
  13. 13.Department of RadiologyBispebjerg and Frederiksberg HospitalFrederiksbergDenmark
  14. 14.Department of RadiologyRigshospitalet-GlostrupGlostrupDenmark
  15. 15.Copenhagen Back and Rehabilitation CentreCopenhagenDenmark
  16. 16.Department of Health Science and TechnologySMI®, Aalborg UniversityAalborgDenmark
  17. 17.RoskildeDenmark
  18. 18.Spine Section, Department of NeurosurgeryAalborg University HospitalAalborgDenmark
  19. 19.Musculoskeletal Statistics Unit, The Parker InstituteCopenhagen University Hospital at Bispebjerg and FrederiksbergCopenhagenDenmark
  20. 20.København NVDenmark

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