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Chapter 2 European guidelines for prevention in low back pain



Summary of the concepts of prevention in low back pain (LBP): • The general nature and course of commonly experienced LBP means that there is limited scope for preventing its incidence (first-time onset). Prevention, in the context of this guideline, is focused primarily on reduction of the impact and consequences of LBP. • Primary causative mechanisms remain largely undetermined: risk factor modification will not necessarily achieve prevention. • There is considerable scope, in principle, for prevention of the consequences of LBP – e.g. episodes (recurrence), care seeking, disability, and workloss. • Different interventions and outcomes will be appropriate for different target populations (general population, workers, and children) yet inevitably there is overlap. • Interventions that are essentially treatments in the clinical environment, focused on management of current symptoms, are not considered as ‘prevention’ for the purposes of this guideline: they are covered in the accompanying clinical guidelines Overarching comments: • Overall, there is limited robust evidence for numerous aspects of prevention in LBP. • Nevertheless, there is evidence suggesting that prevention of various consequences of LBP is feasible. • However, for those interventions where there is acceptable evidence, the effect sizes are rather modest. • The most promising



European Spine JournalSpringer Journals

Published: Mar 1, 2006

DOI: 10.1007/s00586-006-1070-3

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