520: Burden and management of low back pain in adults. Background paper for WHO guideline for the management of chronic low back pain in adults in primary care
Hartvigsen J, Perracini M, Sumi Y
WHO Background paper. 2020.
Low back pain is very common and affects people of all ages. It accounts for 51.1 million years lived with disability and is highest in 126 out of 195 countries and regions representing an increase of 45.6% between 1990 and 2017. Low back pain is the most common reason for sick leave in many countries and the primary reason why older workers retire early. Population ageing is a major contributor to the projected increases of chronic conditions including low back pain. Low back pain is burdensome across the life course, but it is particularly burdensome for older people due to decreasing physical and mental capacities and limitation in functional ability. In spite of available recommendations across international evidence-based clinical practice guidelines, large gaps exist between these recommendations and clinical practice everywhere. Reasons for this evidence-practice gap include lack of knowledge among health workers, lack of evidence-based care pathways in most settings, and importantly a lack of public health policies and global priority in this area.
This guideline is a part of action for the Decade of Healthy Ageing (2020-2030) of the World Health Organization. The response to foster healthy ageing is grounded in ensuring that everyone experience the best functional trajectories across their life course, and that older people receive appropriate care. The main objective of the guideline will be to provide evidence-based recommendation on management of non-specific chronic low back pain across adulthood (older than 19 years) for health workers in primary care. This guideline will significantly contribute to the implementation of WHO approach on integrated centered care for older people (ICOPE) and to the development of a priority package of health services that can be delivered through universal health coverage.