Key Facts:
· Latest evidence on low back pain finds most patients don't need scans, surgery or strong medicines.
· Researchers from Neuroscience Research Australia (NeuRA), UNSW Sydney and the US worked on the review of hundreds of studies to provide clinicians with an up-to-date guide to the assessment and management of low back pain.
· It's hoped the review will provide practical guidance for clinical care and assist patients in receiving tests and treatments that work.
Low back pain affects around 619 million people worldwide, but a new review suggests many are receiving unnecessary scans and ineffectual treatments.
Researchers compiled latest evidence from hundreds of studies to provide clinicians with an up-to-date guide to assist with assessment and management, with "Low Back Pain: A Review" published in JAMA.
Professor James McAuley and Dr Aidan Cashin from the Centre for Pain IMPACT at Neuroscience Research Australia (NeuRA) and UNSW Sydney worked with researchers in the United States on the project that looked at non-specific low back pain.
"Low back pain is one of the most common reasons people seek medical care, yet many patients still receive interventions that are unlikely to help," Prof McAuley said.
"Low back pain is the leading cause of disability globally and despite its enormous impact, many patients continue to receive unnecessary tests and treatments that provide little benefit.
"Our review showed that the biggest challenge in low back pain is now longer a lack of evidence – it's ensuring that patients receive the evidence-based care we already know works."
Why the Review was important
The Review summarised current evidence on the epidemiology, diagnosis, prognosis and treatment of acute and chronic low back pain. Researchers considered a range of studies published in PubMed between January 2005 until February 2026, as well as the most recent clinical practice guidelines published by the World Health Organisation, American College of Physicians and National Institute for Health and Care Excellence.
This review considered a large amount of new evidence and changed recommendations since previous reviews were conducted.
"We now have stronger evidence that routine imaging is often unnecessary and can sometimes lead to overdiagnosis and over treatment," Prof McAuley said.
"We also have better evidence about the limited benefits and potential harms of many medicines commonly used for low back pain, including opioids.
"At the same time, there has been growing evidence supporting approaches that help people remain active, self-manage their condition and address the broader physical, psychological and social factors that can contribute to persistent pain and disability."
What it means for patients
"The purpose of a review like this is to bring together the best available evidence and translate it into practical guidance for clinical care," Dr Cashin said.
"This includes what low back pain is, how it should be assessed, when doctors should be concerned about serious underlying conditions, and which treatments are most likely to help.
"For doctors, this review provides an evidence-based roadmap for diagnosis and management.
"For people with low back pain, this review should help their care reflect what the evidence shows works and be less likely to include tests or treatments that provide little benefit or may even cause harm."
Prof McAuley said the next step for research was to work on closing the gap between evidence and practice.
"The good news is, most low back pain is not caused by a serious underlying condition," Prof McAuley said.
"Most people can recover or improve with evidence-based care that focuses on staying active, managing symptoms and gradually returning to normal activities.
"There's a growing interest in prevention, digital models of scare and scaleable interventions, but ultimately the challenge for the next decade it not only generating new evidence, but ensuring that the evidence we already have reaches the people who need it most."
The review can be found here.
