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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.5

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v21.i1.30
pages 67-97

Evidence-Based Evaluation and Management of Chronic Low Back Pain: Understanding and Using Clinical Practice Guidelines

Roger Chou
Department of Medicine, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, OR, USA

ABSTRACT

Evaluation and management of chronic low back pain is often a challenge. Many treatments are available, each with its own unique profile of benefits, harms, costs, and burdens. In addition, the evidence supporting different treatments is variable. All these factors make it difficult for clinicians to know the best options for management. Clinical practice guidelines are a type of preprocessed evidence that can help clinicians make decisions based on the best available research evidence. However, guidelines can be misleading if they do not follow methods to insure comprehensiveness, methodologic rigor, and transparency. This article explains how clinicians can determine whether a clinical practice guideline is trustworthy, reviews the methods used in several recent higher-quality, multidisciplinary guidelines on evaluation and management of chronic low back pain, describes their recommendations, and highlights areas of discrepancy between the guidelines.


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