The World Health Organization (WHO) has released its first guidelines for addressing low back pain, a condition affecting an estimated 619 million people, or one in 13 worldwide.

The new guidelines are designed to enhance care quality for millions suffering from the condition, offering healthcare professionals a range of non-surgical treatments applicable in primary and community care settings. The guidelines also list treatments to avoid, including lumbar braces, traction-based physical therapies, and opioid painkillers.

The prevalence of low back pain is expected to surge as the global population ages, with estimates predicting a rise to 843 million affected individuals by 2050. Low back pain currently accounts for 8.1% of years lived with disability globally, according to the WHO.

“To achieve universal health coverage, the issue of low back pain cannot be ignored, as it is the leading cause of disability globally,” said Dr Bruce Aylward, WHO assistant director-general for universal health coverage and life course, in a press release accompanying the guideline launch.

Nine out of ten cases of low back pain are chronic, deeply affecting patients’ ability to work and stay active in family and social life, often leading to broader economic and mental health consequences. The guidelines emphasise mental health care as crucial in treating these conditions.

Chronic low back pain also has significant economic repercussions at the national level, pushing individuals out of the workforce and straining health systems.

The annual global costs associated with low back pain exceed $50 billion and potentially reach up to $100 billion at the upper end of estimates, according to the British Medical Journal. This financial impact is especially pronounced in low- and middle-income countries (LMICs), where 80-90% of employment involves heavy labour, significantly increasing the prevalence of LBP compared to high-income nations.

The WHO guidelines provide a multifaceted approach to treatment, emphasising patient education in self-care techniques, structured exercise programs, spinal manipulative therapy, and massage, while cautioning against certain treatments like traction and therapeutic ultrasound.

WHO officials emphasised that while the guidelines provide a general framework, adapting them to local clinical practices is essential for effective implementation.

“Addressing chronic low back pain requires an integrated, person-centred approach,” said Banerjee. “This means considering each person’s unique situation and the factors that might influence their pain experience.”

Recognising low back pain as a national health priority is crucial for optimising healthcare management in this area, WHO stressed – a step many countries have yet to take.

Image Credits: Adam McGuffie.