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

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

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.