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Article
Mapping guideline-informed care for chronic non-specific low back pain with the biopsychosocial approach: A rapid review
Pain Practice (2023)
  • Matthew Leach
  • Mike Climstein
  • G Fryer
  • S Kumar
  • T Agnew
Abstract
Background
Current evidence favours a multidisciplinary biopsychosocial approach to the management of chronic non-specific low back pain (CLBP). However, it is unclear whether such an approach is facilitated by current clinical guidelines. This rapid review set out to examine the extent to which clinical guideline recommendations for managing CLBP address domains of the biopsychosocial approach.
Methods
MEDLINE, EMBASE, CINAHL, and the grey literature were searched for any clinical guidelines targeting the management of CLBP, published within the last 6 years. Title/abstract and full-text screening were undertaken by two reviewers using the accelerated approach. Data extraction and critical appraisal were completed by two reviewers, independently. Extracted data were synthesised in narrative form.
Results
Fifteen guidelines met the review inclusion criteria. One-half of the guidelines were considered to be of medium quality. All guidelines provided management recommendations addressing the biological domain of the biopsychosocial approach; 13 (87%) guidelines reported recommendations addressing the psychological domain, and 8 (53%) guidelines presented recommendations addressing the social domain. Only 53% (8/15) of guidelines reported recommendations addressing all 3 domains of the biopsychosocial approach. Guideline recommendations both across and within the biopsychosocial domains were varied and inconsistent.
Conclusions
The CLBP clinical guidelines included in this review provided detailed guidance on the biological domain, yet limited attention and detail were afforded to the psychological and social domains. Several recommendations are presented on how to improve the quality of future CLBP guidelines, and to help foster the provision of a biopsychosocial approach to CLBP management.
Keywords
  • Low back pain,
  • biopsychosocial,
  • evidence,
  • best practice,
  • chronic,
  • non-specific low back pain
Publication Date
March, 2023
DOI
10.1111/papr.13214
Citation Information
Matthew Leach, Mike Climstein, G Fryer, S Kumar, et al.. "Mapping guideline-informed care for chronic non-specific low back pain with the biopsychosocial approach: A rapid review" Pain Practice (2023)
Available at: http://works.bepress.com/michael_climstein/185/