Introduction
The World Health Organization (WHO) has recently unveiled a groundbreaking guideline for the non-surgical management of chronic primary low back pain in adults, particularly in primary and community care settings. This announcement, made in Toronto on December 7, 2023, marks a significant shift in the global approach to back pain management.
Key Endorsements and Recommendations
The guideline, influenced by the EPIC (evidence-based, people-centered, interprofessional, and collaborative) principles proposed by the WFC in 2017, received a boost from Professor Andrew Briggs, who led its launch at the 17th WFC Biennial Congress in Australia. Notably, spinal manipulation, a core chiropractic therapy, alongside other physical therapies like dry needling, structured exercise, and massage, received strong recommendations.
Rejection of Conventional Methods
Interestingly, the guideline discourages certain traditional methods such as TENS, therapeutic ultrasound, traction, lumbar braces/supports, and most pharmacological interventions, including opioids, benzodiazepines, and antidepressants. Non-steroidal anti-inflammatory medication received only a conditional nod.
Biopsychosocial Approach
Emphasizing a biopsychosocial framework, the guideline advocates for multicomponent interventions, echoing long-standing recommendations by the WFC. The focus is on understanding and integrating patient needs, preferences, and contexts into treatment plans, emphasizing the importance of shared decision-making.
WFC's Response
WFC Secretary-General Richard Brown hailed the guideline as a validation of practices employed by evidence-based chiropractors worldwide. He underlined the guideline's alignment with chiropractic care's emphasis on empathic communication, hands-on treatment, lifestyle advice, and support for collaborative care models.
Impact on Chiropractic Integration
This endorsement from WHO is seen as a strong argument for integrating chiropractic care into health systems globally, irrespective of the country's economic status.
Conclusion and Further Reading
The new WHO guideline, developed with inputs from chiropractic professionals including WFC Research Committee Chair Dr. Sidney Rubinstein, represents a pivotal moment in chiropractic care and its role in managing low back pain. To explore the full guideline, executive summary, and recommendations, visit the WHO publication Here.