Evidence map›Paper›PMID 38693474›Full record

ArticleBMC musculoskeletal disorders2024

Recent clinical practice guidelines for the management of low back pain: a global comparison.

Tianyu Zhou, David Salman, Alison H McGregor

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  7. Effect of Therapeutic Exercise on the Management of Hyperkyphosis in Adolescence and Young Adulthood: A Systematic Review.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025
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  16. Early functional training is not superior to routine rehabilitation in improving walking distance and multifidus atrophy after lumbar fusion: a randomized controlled trial with 6-month follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
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  20. Is therapeutic exercise as a standalone intervention effective in reducing kinesiophobia in adults with nonspecific chronic low back pain? A systematic review and meta-analysis with meta-regression.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Tianyu ZhouMSk lab, Department of Surgery & Cancer, Imperial College London, London, 2nd Floor, Sir Michael Uren Hub, 86 Wood Lane, W12 0BZ, UK. t.zhou20@imperial.ac.uk.ORCID http://orcid.org/0000-0002-8785-8493
David SalmanMSk lab, Department of Surgery & Cancer, Imperial College London, London, 2nd Floor, Sir Michael Uren Hub, 86 Wood Lane, W12 0BZ, UK.ORCID http://orcid.org/0000-0002-1481-8829
Alison H McGregorMSk lab, Department of Surgery & Cancer, Imperial College London, London, 2nd Floor, Sir Michael Uren Hub, 86 Wood Lane, W12 0BZ, UK.ORCID http://orcid.org/0000-0003-4672-332X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow back pain (LBP) is a significant health problem worldwide, with a lifetime prevalence of 84% in the general adult population. To rationalise the management of LBP, clinical practice guidelines (CPGs) have been issued in various countries around the world. This study aims to identify and compare the recommendations of recent CPGs for the management of LBP across the world.

methodsMEDLINE, EMBASE, CINAHL, PEDro, and major guideline databases were searched from 2017 to 2022 to identify CPGs. CPGs focusing on information regarding the management and/or treatment of non-specific LBP were considered eligible. The quality of included guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.

resultsOur analysis identified a total of 22 CPGs that met the inclusion criteria, and were of middle and high methodological quality as assessed by the AGREE II tool. The guidelines exhibited heterogeneity in their recommendations, particularly in the approach to different stages of LBP. For acute LBP, the guidelines recommended the use of non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic exercise, staying active, and spinal manipulation. For subacute LBP, the guidelines recommended the use of NSAIDs, therapeutic exercise, staying active, and spinal manipulation. For chronic LBP, the guidelines recommended therapeutic exercise, the use of NSAIDs, spinal manipulation, and acupuncture.

conclusionsCurrent CPGs provide recommendations for almost all major aspects of the management of LBP, but there is marked heterogeneity between them. Some recommendations lack clarity and overlap with other treatments within the guidelines.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalLow Back PainPractice Guidelines as TopicChronic PainExercise TherapyHumansManipulation, SpinalPain ManagementAnti-Inflammatory Agents, Non-SteroidalClinical practice guidelinesLow back painManagementReviewTreatment

Identifiers

PMID38693474
PMCPMC11061926

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.