Original Title: Guía de práctica clínica sobre lumbalgia

Authors' objectives: The aim of these guidelines to enhance the health care of patients with acute, subacute and chronic low-back pain in the area of primary health care, the main users being the health care personnel who treat patients with low-back pain at an extrahospital level.

Authors' results and conclusions: Questions to be answered 1. What is the validity of the clinical examination for the diagnosis of non-specific acute low-back pain or in order to rule out major organic pathology? 2. What is the diagnostic validity of the radiography (X-ray) of the lumbar spine for the diagnosis of non-specific acute low-back pain or in order to rule out major organic pathology? 3. Does the performance of a radiograph reduce the use of services, clinical examination and disability of persons with low-back pain? 4. What is the diagnostic validity of image tests such as the CAT/RNM for the diagnosis of non-specific low-back pain? 5. What are the risk factors for sufferers of low-back pain? 6. What is the natural development of non-specific acute low-back pain? 7. Is it possible to predict the development of chronic low-back pain in persons with an episode of acute low-back pain? 8. Is the information provided to patients efficacious in the treatment of non-specific lowback pain? 9. Is it efficacious to remain active in the treatment of non-specific low-back pain? 10. Is remaining in bed efficacious in the handling of non-specific low-back pain? 11. Is doing exercise efficacious in the treatment of non-specific low-back pain? 12. Are paracetamol and analgesics efficacious in the treatment of low-back pain? 13. Are NSAIDs efficacious in the treatment of low-back pain? In regular doses or on demand? 14. Are opiates efficacious in the treatment of low-back pain? 15. Are muscular relaxants efficacious in the treatment of low-back pain? 16. Are antidepressants efficacious in the treatment of low-back pain? 17. Is capsaicine efficacious in the treatment of low-back pain? 18. Are intramuscular (IM) or oral corticoids efficacious in the treatment of low-back pain? 19. Is vitamin B efficacious in the treatment of low-back pain? 20. Is massage efficacious in the treatment of non-specific low-back pain? 21. Is manipulation efficacious in the treatment of low-back pain? 22. Is the use of heat/cold in the lower back area (surface thermotherapy) efficacious in the treatment of low-back pain? 23. Is TENS efficacious in the treatment of non-specific low-back pain? 24. Is traction efficacious in the treatment of low-back pain? 25. Are girdles/corsets efficacious in the treatment of non-specific acute low-back pain? 26. Is acupuncture efficacious in the treatment of non-specific low-back pain? 27. Is neuroreflexotherapy efficacious in the treatment of non-specific low-back pain? 28. Are infiltrations efficacious in low-back pain? 29. Is ozonotherapy efficacious in the treatment of unspecific low-back pain? 30. Is surgery appropriate in non-specific chronic low-back pain? 31. Is physical exercise efficacious in the prevention of recurrences of low-back pain? 32. Are girdles efficacious to prevent recurrences in the treatment of low-back pain?

Authors' recommendations: Relating to diagnostics, risk factors, prognosis and treatment of acute, sub-acute and chronic low-back pain.

Authors' methods: Adaptation-updating of Clinical Practice Guidelines (CPG). The classification of evidence and grading of recommendations recommended by the National Institute of Clinical Excelence (NICE), which uses the SIGN method for studies of treatment and prognosis, and of the Centre for Evidence-Based Medicine of Oxford for diagnostics studies, have been used. SEARCH STRATEGY: Cochrane reviews and other CPG at an international level have been used as a starting point for our study. When the questions required a total or partial updating and drafting “de novo”, the methodology proposed by NICE in its guidelines preparation manual have been used. To do this, searches were made in the Cochrane Library, Medline-PubMed, DARE, Evidence Based Review, EMBASE, PEDro, Kovacs. The search period of words was extended to January-March 1/2 2006, depending on the question. INCLUSION AND EXCLUSION CRITERIA: High-quality CPGs selected on the basis of the AGREE evaluation instrument and published as of 2002. Articles published up until 2006 and selected on the basis of an evaluation of the evidence according to the critical reading templates of the Scottish Intercollegiate Guidelines Network (SIGN), by two evaluators.

Project Status: Completed

Year Published: 2007

URL for published report: https://www.euskadi.eus/contenidos/informacion/osteba_publicaciones/es_osteba/adjuntos/gpc_07-1%20lumbalgia.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government