Recent highlights in low back pain research, Part II: Prevention and management

IF 9.4 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI:10.1016/j.jphys.2026.03.002

Bruno T. Saragiotto , Christina Abdel Shaheed , Mark Overton , Jill A. Hayden , Jan Hartvigsen , Rafael Zambelli Pinto

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引用次数: 0

Abstract

Introduction

This paper highlights research relating to the prevention and management of non-specific low back pain (LBP) published between January 2020 and December 2025.

Methods

To identify studies for inclusion, MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews were searched. Relevant studies were grouped according to topic area. From those results, studies that were perceived to be of great clinical importance and particularly high quality were selected.

Results

This narrative review synthesised five key themes in contemporary LBP management. Theme 1 (Prevention) demonstrated consistent evidence that exercise-based programs, particularly when combined with education, reduce the risk and impact of recurrent LBP. Theme 2 (Non-pharmacological management) showed that education, exercise, manual therapy, acupuncture and psychologically informed approaches generally produce small to moderate effects on average, with the strongest and most sustained benefits observed for exercise and psychologically informed approaches. In Theme 3 (Pharmacological management), it was found that commonly used medicines provide at best small benefits while carrying meaningful risks, reinforcing their limited and time-restricted role in care. Theme 4 (Invasive and surgical interventions) highlighted that most invasive procedures offer little to no meaningful benefit for LBP and expose patients to substantial harm and cost. Finally, Theme 5 (Special populations) showed that older adults, children, adolescents, and Indigenous and underserved communities remain under-represented in clinical trials and are more likely to receive non-guideline concordant care, emphasising the need for tailored, equity-oriented approaches.

Conclusion

LBP care is most effective when it is active and person‑centred. Education, exercise and psychologically informed approaches should be prioritised, while medicines and invasive procedures offer little benefit and carry risk; care should be tailored to reduce persistent inequities across populations.

查看原文本刊更多论文

最近腰痛研究的亮点，第二部分：预防和管理。

本文重点介绍了2020年1月至2025年12月期间发表的有关预防和管理非特异性腰痛（LBP）的研究。方法：检索MEDLINE、CINAHL和Cochrane系统评价数据库，确定纳入的研究。将相关研究按主题领域进行分组。从这些结果中，选择那些被认为具有重要临床意义和特别高质量的研究。结果：本综述综合了当代LBP管理的五个关键主题。主题1（预防）展示了一致的证据，即以运动为基础的项目，特别是与教育相结合，可以降低复发性腰痛的风险和影响。主题2（非药物管理）显示，教育、运动、手工疗法、针灸和心理知情方法一般平均产生小到中等的效果，其中运动和心理知情方法的效果最强、最持久。在主题3（药理学管理）中，发现常用药物最多只能提供很小的好处，同时也存在重大风险，从而加强了它们在护理中有限和有时间限制的作用。主题4（侵入性和外科干预）强调，大多数侵入性手术对LBP几乎没有任何有意义的益处，并使患者面临巨大的伤害和成本。最后，主题5（特殊人群）表明，老年人、儿童、青少年、土著和服务不足的社区在临床试验中的代表性仍然不足，更有可能接受非指南的和谐护理，强调需要量身定制、以公平为导向的方法。结论：积极主动、以人为本的腰痛护理是最有效的。应优先考虑教育、锻炼和心理知情方法，而药物和侵入性手术几乎没有好处，而且存在风险；医疗服务应量身定制，以减少人群之间持续存在的不平等现象。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Physiotherapy ORTHOPEDICS-REHABILITATION

CiteScore

11.40

自引率

7.40%

发文量

审稿时长

72 days

期刊介绍： The Journal of Physiotherapy is the official journal of the Australian Physiotherapy Association. It aims to publish high-quality research with a significant impact on global physiotherapy practice. The journal's vision is to lead the field in supporting clinicians to access, understand, and implement research evidence that will enhance person-centred care. In January 2008, the Journal of Physiotherapy became the first physiotherapy journal to adhere to the ICMJE requirement of registering randomized trials with a recognized Trial Registry. The journal prioritizes systematic reviews, clinical trials, economic analyses, experimental studies, qualitative studies, epidemiological studies, and observational studies. In January 2014, it also became the first core physiotherapy/physical therapy journal to provide free access to editorials and peer-reviewed original research. The Australian Physiotherapy Association extended their support for excellence in physiotherapy practice by sponsoring open access publication of all Journal of Physiotherapy content in 2016. As a result, all past, present, and future journal articles are freely accessible, and there are no author fees for publication.