Avoid opioids for backache – WHO

Health services should avoid some common physical therapies and the use of opioids for low back pain, according to new global guidance.

The World Health Organization says that traction-based treatments together with lumbar braces and supports may do more harm than good.

WHO’s first ever guidance on the problem – which currently affects more than 600 million people worldwide – backs spinal manipulative therapy and massage.

It also supports exercise programmes, psychological therapies, education programmes and medicines such as non-steroidal anti-inflammatory medicines.

It warns against prescribing opioids because they can lead to dependence and overdose.

WHO assistant director-general Dr Bruce Aylward said: “To achieve universal health coverage, the issue of low back pain cannot be ignored, as it is the leading cause of disability globally.

“Countries can address this ubiquitous but often-overlooked challenge by incorporating key, achievable interventions, as they strengthen their approaches to primary health care.”

Dr Anshu Banerjee, WHO director for ageing, added: “Addressing chronic low back pain requires an integrated, person-centred approach. This means considering each person’s unique situation and the factors that might influence their pain experience.

“We are using this guideline as a tool to support a holistic approach to chronic low back pain care and to improve the quality, safety and availability of care.”


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