Musculoskeletal disorders as a group are now the largest contributor to years lived with disability (YLDs) around the world (representing 18.5% of the total). Of that, low back pain (LBP) remains the leading cause of years lived with disability (YLDs), constituting approximately HALF of the MSK burden!

Despite the availability of numerous clinical interventions aimed at improving this condition, there was a nearly 3-fold increase in the prevalence of chronic LBP between 1992 and 2006. With annual direct and indirect expenditures expected to exceed $100 billion per year in the United States, the need for effective treatments is underscored.

 
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Diagnosis of LBP can be difficult, as research indicates that 90% of LBP cases are nonspecific in nature, compared with only 5% that present as a specific nerve root distribution from either a compression, prolapsed disc, spinal stenosis or surgical scar. As such, clinicians are challenged in correctly diagnosing LBP and are thus at risk of providing inefficient treatment, should they be incorrect in their diagnosis. Adherence to evidence-based clinical practice guidelines can minimize this potential problem; however, despite the numerous guidelines available and the shift towards recommending approaches including spinal manipulative therapy (SMT), there has been slow uptake of practice guidelines by health care providers. To address this, these authors synthesized the best available evidence on the diagnosis and treatment of LBP using SMT alone or in combination with other conservative treatments, in order to provide up-to-date guidelines for clinicians…LOG IN OR SUBSCRIBE TO ACCESS THE FULL REVIEW!
 
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