TY - JOUR
T1 - Occupational health guidelines for the management of low back pain
T2 - an international comparison
AU - Staal, J. B.
AU - Hlobil, H.
AU - Van Tulder, M. W.
AU - Waddell, G.
AU - Burton, A. K.
AU - Koes, B. W.
AU - Van Mechelen, W.
PY - 2003/9/1
Y1 - 2003/9/1
N2 - Background: The enormous socioeconomic burden of low back pain emphasises the need for effective management of this problem, especially in an occupational context. To address this, occupational guidelines have been issued in various countries. Aims: To compare available international guidelines dealing with the management of low back pain in an occupational health care setting. Methods: The guidelines were compared regarding generally accepted quality criteria using the AGREE instrument, and also summarised regarding the guideline committee, the presentation, the target group, and assessment and management recommendations (that is, advice, return to work strategy, and treatment). Results and Conclusions: The results show that the quality criteria were variously met by the guidelines. Common flaws concerned the absence of proper external reviewing in the development process, lack of attention to organisational barriers and cost implications, and lack of information on the extent to which editors and developers were independent. There was general agreement on numerous issues fundamental to occupational health management of back pain. The assessment recommendations consisted of diagnostic triage, screening for "red flags" and neurological problems, and the identification of potential psychosocial and workplace barriers for recovery. The guidelines also agreed on advice that low back pain is a self limiting condition and, importantly, that remaining at work or an early (gradual) return to work, if necessary with modified duties, should be encouraged and supported.
AB - Background: The enormous socioeconomic burden of low back pain emphasises the need for effective management of this problem, especially in an occupational context. To address this, occupational guidelines have been issued in various countries. Aims: To compare available international guidelines dealing with the management of low back pain in an occupational health care setting. Methods: The guidelines were compared regarding generally accepted quality criteria using the AGREE instrument, and also summarised regarding the guideline committee, the presentation, the target group, and assessment and management recommendations (that is, advice, return to work strategy, and treatment). Results and Conclusions: The results show that the quality criteria were variously met by the guidelines. Common flaws concerned the absence of proper external reviewing in the development process, lack of attention to organisational barriers and cost implications, and lack of information on the extent to which editors and developers were independent. There was general agreement on numerous issues fundamental to occupational health management of back pain. The assessment recommendations consisted of diagnostic triage, screening for "red flags" and neurological problems, and the identification of potential psychosocial and workplace barriers for recovery. The guidelines also agreed on advice that low back pain is a self limiting condition and, importantly, that remaining at work or an early (gradual) return to work, if necessary with modified duties, should be encouraged and supported.
KW - low back pain
KW - occupational
KW - guidelines
UR - http://www.scopus.com/inward/record.url?scp=0042528207&partnerID=8YFLogxK
U2 - 10.1136/oem.60.9.618
DO - 10.1136/oem.60.9.618
M3 - Article
C2 - 12937181
AN - SCOPUS:0042528207
VL - 60
SP - 618
EP - 626
JO - Occupational and Environmental Medicine
JF - Occupational and Environmental Medicine
SN - 1351-0711
IS - 9
ER -