Table 5.
Consistency of recommendations across low back pain vs neck pain guidelines
| Intervention | Low Back Pain | Neck Pain | ||
|---|---|---|---|---|
| No. guidelines (countries) | Overall strength of recommendation | No. guidelines (countries) | Overall strength of recommendation | |
| Reassurance (advice) | 4(4) | Weak FOR | 3(3) | Weak FOR |
| Advice and Education (advice) | 10(8) | Strong FOR | 5(5) | Weak FOR |
| Remain active (advice) | 9(6) | Strong FOR | 2(2) | Weak FOR |
| Encourage physical exercise (advice) | 7(6) | Weak FOR | 3(3) | Weak FOR |
| Continue/return to work (advice) | 2(2) | Weak FOR | 1(1) | (For) |
| Bed rest (advice) | 6(4) | Strong AGAINST WITH EXCEPTIONS | 1(1) | (Against) |
| Analgesics incl. for neuropathic pain | 1(1) | (For) | 2(2) | Weak FOR |
| Paracetamol | 8(6) | Moderate AGAINST | 2(2) | Weak FOR |
| NSAIDs | 9(7) | Inconsistent | 4(3) | Weak FOR |
| Opioids (including tramadol) +/‐ paracetamol (or NSAIDs) | 8(6) | Inconsistent | 2(1) | Weak FOR |
| Antidepressants | 6(5) | Strong AGAINST WITH EXCEPTIONS | ||
| Anticonvulsants/Antiepileptics | 5(5) | Strong AGAINST | ||
| Muscle relaxants | 5(4) | Strong AGAINST WITH EXCEPTIONS | ||
| Topical medications incl. NSAIDS | 3(3) | Inconclusive | 2(2) | Moderate FOR |
| Spinal injections [for non‐specific LBP] | 6(5) | Strong AGAINST | ||
| Spinal epidural steroid injection | 5(5) | Inconsistent | 1(1) | (For) |
| Other injections | 2(2) | Inconclusive | ||
| Thermotherapy | 5(4) | Inconsistent | 2(2) | Inconclusive |
| Manual therapy | 8(6) | Inconsistent | 5(4) | Inconsistent |
| Manual therapy combined with other treatment | 4(3) | Moderate FOR | 3(3) | Moderate FOR |
| Exercise programs/therapy | 9(6) | Strong FOR | 5(5) | Moderate FOR |
| Exercise therapy combined with other treatment | 2(2) | Moderate FOR | ||
| Group exercise programmes/back schools | 3(3) | Moderate FOR | ||
| Postural therapies | 3(3) | Inconclusive | ||
| Traction | 6(6) | Strong AGAINST | 3(3) | Inconclusive |
| Electrotherapy | 6(6) | Strong AGAINST | 4(4) | Inconclusive |
| Orthoses | 6(6) | Strong AGAINST | 4(4) | Inconclusive |
| Acupuncture | 5(4) | Inconsistent | 4(3) | Inconsistent |
| Psychological therapies | 4(3) | Strong FOR SPECIFIC SUBGROUPS | 3(3) | Weak FOR SPECIFIC SUBGROUPS |
| Psychological therapies combined with other treatment | 2(2) | Moderate FOR | ||
| Multidisciplinary treatment | 7(5) | Strong FOR SPECIFIC SUBGROUPS | 2(2) | Weak FOR SPECIFIC SUBGROUPS |
| Work‐based interventions | 3(3) | Moderate FOR | ||
| Return to work programmes | 3(3) | Strong FOR | ||
| Imaging | 9(6) | Strong AGAINST WITH EXCEPTIONS | 2(2) | Inconclusive |
| To surgeon/surgery | 8(6) | Strong FOR SPECIFIC SUBGROUPS |
Appendix S1 Appendix S2 Appendix S3 Appendix S4 Appendix S5 Appendix S6 Appendix S7 |
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