Non-specific low back pain: interpretation of North American Spine Society (NASS) guidelines for evidence-based medicine_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHI Yubo , GUO Weichun ,  YU Ling

Department of Spinal Surgery, Renmin Hospital of Wuhan University, Wuhan Hubei, 430060, P.R.China;

Corresponding author：

YU Ling, Email: scaling@whu.edu.cn

Keywords：

Non-specific low back pain; diagnosis; treatment; guideline

DOI：

10.7507/1002-1892.202103131

Video：

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Low back pain is a common disease. In 2020, the North American Spine Society (NASS) formulated an evidence-based clinical guideline for the diagnosis and treatment of non-specific low back pain. The guidelines mainly addressed five aspects of non-specific low back pain: diagnosis, imaging examination, conservative treatment, interventional treatment, and surgical treatment. Based on an in-depth understanding of the guidelines, this article gives a brief explanation of the diagnosis and treatment of non-specific low back pain, so as to provide references for clinicians.

Citation： SHI Yubo, GUO Weichun, YU Ling. Non-specific low back pain: interpretation of North American Spine Society (NASS) guidelines for evidence-based medicine. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(10): 1336-1340. doi: 10.7507/1002-1892.202103131 Copy

1.	Vlaeyen JWS, Maher CG, Wiech K, et al. Low back pain. Nat Rev Dis Primers, 2018, 4(1): 52. doi: 10.1038/s41572-018-0052-1.
2.	Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet, 2017, 389: 736-747.
3.	Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet, 2018, 391(10137): 2356-2367.
4.	Kreiner DS, Matz P, Bono CM, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J, 2020, 20(7): 998-1024.
5.	Matsudaira K, Konishi H, Miyoshi K, et al. Potential risk factors of persistent low back pain developing from mild low back pain in urban Japanese workers. PLoS One, 2014, 9(4): e93924. doi: 10.1371/journal.pone.0093924.
6.	Shaw WS, Pransky G, Patterson W, et al. Early disability risk factors for low back pain assessed at outpatient occupational health clinics. Spine (Phila Pa 1976), 2005, 30(5): 572-580.
7.	Coste J, Lefrançois G, Guillemin F, et al. Prognosis and quality of life in patients with acute low back pain: insights from a comprehensive inception cohort study. Arthritis Rheum, 2004, 51(2): 168-176.
8.	Will JS, Bury DC, Miller JA. Mechanical low back pain. Am Fam Physician, 2018, 98(7): 421-428.
9.	Kerry S, Hilton S, Dundas D, et al. Radiography for low back pain: a randomised controlled trial and observational study in primary care. Br J Gen Pract, 2002, 52(479): 469-474.
10.	Lakadamyali H, Tarhan NC, Ergun T, et al. STIR sequence for depiction of degenerative changes in posterior stabilizing elements in patients with lower back pain. AJR Am J Roentgenol, 2008, 191(4): 973-979.
11.	Carragee E, Alamin T, Cheng I, et al. Are first-time episodes of serious LBP associated with new MRI findings? Spine J, 2006, 6(6): 624-635.
12.	Wiikeri M, Nummi J, Riihimäki H, et al. Radiologically detectable lumbar disc degeneration in concrete reinforcement workers. Scand J Work Environ Health, 1978, 4 Suppl 1: 47-53.
13.	Frerick H, Keitel W, Kuhn U, et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain, 2003, 106(1-2): 59-64.
14.	Kettenmann B, Wille C, Lurie-Luke E, et al. Impact of continuous low level heatwrap therapy in acute low back pain patients: subjective and objective measurements. Clin J Pain, 2007, 23(8): 663-668.
15.	Marchand S, Charest J, Li J, et al. Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain, 1993, 54(1): 99-106.
16.	Deyo RA, Walsh NE, Martin DC, et al. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med, 1990, 322(23): 1627-1634.
17.	Borman P, Keskin D, Bodur H. The efficacy of lumbar traction in the management of patients with low back pain. Rheumatol Int, 2003, 23(2): 82-86.
18.	陈丽霞, 丁颖, 沈爱云, 等. 颊针治疗慢性非特异性下腰痛的临床疗效. 江苏医药, 2021, 47(4): 404-406.
19.	Calmels P, Queneau P, Hamonet C, et al. Effectiveness of a lumbar belt in subacute low back pain: an open, multicentric, and randomized clinical study. Spine (Phila Pa 1976), 2009, 34(3): 215-220.
20.	Oleske DM, Lavender SA, Andersson GB, et al. Are back supports plus education more effective than education alone in promoting recovery from low back pain?: Results from a randomized clinical trial. Spine (Phila Pa 1976), 2007, 32(19): 2050-2057.
21.	罗明辉. 普拉提运动对慢性下腰痛患者的疼痛和腰椎功能的影响. 基因组学与应用生物学, 2019, 38(7): 3263-3267.
22.	Civelek E, Cansever T, Kabatas S, et al. Comparison of effectiveness of facet joint injection and radiofrequency denervation in chronic low back pain. Turk Neurosurg, 2012, 22(2): 200-206.
23.	Golob AL, Wipf JE. Low back pain. Med Clin North Am, 2014, 98(3): 405-428.

1. Vlaeyen JWS, Maher CG, Wiech K, et al. Low back pain. Nat Rev Dis Primers, 2018, 4(1): 52. doi: 10.1038/s41572-018-0052-1.
2. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet, 2017, 389: 736-747.
3. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet, 2018, 391(10137): 2356-2367.
4. Kreiner DS, Matz P, Bono CM, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J, 2020, 20(7): 998-1024.
5. Matsudaira K, Konishi H, Miyoshi K, et al. Potential risk factors of persistent low back pain developing from mild low back pain in urban Japanese workers. PLoS One, 2014, 9(4): e93924. doi: 10.1371/journal.pone.0093924.
6. Shaw WS, Pransky G, Patterson W, et al. Early disability risk factors for low back pain assessed at outpatient occupational health clinics. Spine (Phila Pa 1976), 2005, 30(5): 572-580.
7. Coste J, Lefrançois G, Guillemin F, et al. Prognosis and quality of life in patients with acute low back pain: insights from a comprehensive inception cohort study. Arthritis Rheum, 2004, 51(2): 168-176.
8. Will JS, Bury DC, Miller JA. Mechanical low back pain. Am Fam Physician, 2018, 98(7): 421-428.
9. Kerry S, Hilton S, Dundas D, et al. Radiography for low back pain: a randomised controlled trial and observational study in primary care. Br J Gen Pract, 2002, 52(479): 469-474.
10. Lakadamyali H, Tarhan NC, Ergun T, et al. STIR sequence for depiction of degenerative changes in posterior stabilizing elements in patients with lower back pain. AJR Am J Roentgenol, 2008, 191(4): 973-979.
11. Carragee E, Alamin T, Cheng I, et al. Are first-time episodes of serious LBP associated with new MRI findings? Spine J, 2006, 6(6): 624-635.
12. Wiikeri M, Nummi J, Riihimäki H, et al. Radiologically detectable lumbar disc degeneration in concrete reinforcement workers. Scand J Work Environ Health, 1978, 4 Suppl 1: 47-53.
13. Frerick H, Keitel W, Kuhn U, et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain, 2003, 106(1-2): 59-64.
14. Kettenmann B, Wille C, Lurie-Luke E, et al. Impact of continuous low level heatwrap therapy in acute low back pain patients: subjective and objective measurements. Clin J Pain, 2007, 23(8): 663-668.
15. Marchand S, Charest J, Li J, et al. Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain, 1993, 54(1): 99-106.
16. Deyo RA, Walsh NE, Martin DC, et al. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med, 1990, 322(23): 1627-1634.
17. Borman P, Keskin D, Bodur H. The efficacy of lumbar traction in the management of patients with low back pain. Rheumatol Int, 2003, 23(2): 82-86.
18. 陈丽霞, 丁颖, 沈爱云, 等. 颊针治疗慢性非特异性下腰痛的临床疗效. 江苏医药, 2021, 47(4): 404-406.
19. Calmels P, Queneau P, Hamonet C, et al. Effectiveness of a lumbar belt in subacute low back pain: an open, multicentric, and randomized clinical study. Spine (Phila Pa 1976), 2009, 34(3): 215-220.
20. Oleske DM, Lavender SA, Andersson GB, et al. Are back supports plus education more effective than education alone in promoting recovery from low back pain?: Results from a randomized clinical trial. Spine (Phila Pa 1976), 2007, 32(19): 2050-2057.
21. 罗明辉. 普拉提运动对慢性下腰痛患者的疼痛和腰椎功能的影响. 基因组学与应用生物学, 2019, 38(7): 3263-3267.
22. Civelek E, Cansever T, Kabatas S, et al. Comparison of effectiveness of facet joint injection and radiofrequency denervation in chronic low back pain. Turk Neurosurg, 2012, 22(2): 200-206.
23. Golob AL, Wipf JE. Low back pain. Med Clin North Am, 2014, 98(3): 405-428.

Chinese Journal of Reparative and Reconstructive Surgery

Non-specific low back pain: interpretation of North American Spine Society (NASS) guidelines for evidence-based medicine

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