European guidelines for the management of low back pain.

Low back pain is a tremendous health care and socioeconomic problem (van Tulder et al. 1995). Utilization of limited resources available at an early point in time may prevent the development of unnecessary suffering and related costs. Several approaches to the prevention of back pain have been reported in the literature, but there still is a lack of clarity regarding which types of interventions are employed as well as the effectiveness of them (Linton and van Tulder 2001). Prevention of the occurrence of low back pain and prevention of chronic low back pain and disability are major challenges. Non-speciŽ c low back pain represents a large majority of cases (Deyo and Weinstein 2001) and there is great variability in its clinical management. Low back pain is most commonly treated in primary health care settings. The diagnostic and therapeutic management of patients with acute as well as chronic low back pain seems to vary substantially among health care providers (e.g., general practitioners, medical specialists, physical therapists, chiropractors, osteopaths, manual therapists) within European countries. However, there are also considerable discrepancies in the management of low back pain between countries in Europe and elsewhere, so there is a need to increase consistency in the management of low back pain across professions and countries. European guidelines for the management of low back pain