Occupational health guidelines for the management of low back pain: an international comparison

J B Staal, H Hlobil, M W van Tulder, G Waddell, A K Burton, B W Koes, W van Mechelen

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)618-26
Number of pages9
JournalOccupational and Environmental Medicine
Volume60
Issue number9
Publication statusPublished - Sep 2003

Cite this

Staal, J. B., Hlobil, H., van Tulder, M. W., Waddell, G., Burton, A. K., Koes, B. W., & van Mechelen, W. (2003). Occupational health guidelines for the management of low back pain: an international comparison. Occupational and Environmental Medicine, 60(9), 618-26.
Staal, J B ; Hlobil, H ; van Tulder, M W ; Waddell, G ; Burton, A K ; Koes, B W ; van Mechelen, W. / Occupational health guidelines for the management of low back pain : an international comparison. In: Occupational and Environmental Medicine. 2003 ; Vol. 60, No. 9. pp. 618-26.
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Staal, JB, Hlobil, H, van Tulder, MW, Waddell, G, Burton, AK, Koes, BW & van Mechelen, W 2003, 'Occupational health guidelines for the management of low back pain: an international comparison' Occupational and Environmental Medicine, vol. 60, no. 9, pp. 618-26.

Occupational health guidelines for the management of low back pain : an international comparison. / Staal, J B; Hlobil, H; van Tulder, M W; Waddell, G; Burton, A K; Koes, B W; van Mechelen, W.

In: Occupational and Environmental Medicine, Vol. 60, No. 9, 09.2003, p. 618-26.

Research output: Contribution to journalReview articleAcademicpeer-review

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

Y1 - 2003/9

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: andCONCLUSIONS: 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: andCONCLUSIONS: 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 - Disability Evaluation

KW - Humans

KW - Low Back Pain/rehabilitation

KW - Occupational Health

KW - Practice Guidelines as Topic/standards

KW - Socioeconomic Factors

M3 - Review article

VL - 60

SP - 618

EP - 626

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

SN - 1351-0711

IS - 9

ER -

Staal JB, Hlobil H, van Tulder MW, Waddell G, Burton AK, Koes BW et al. Occupational health guidelines for the management of low back pain: an international comparison. Occupational and Environmental Medicine. 2003 Sep;60(9):618-26.