Primary prevention

There is limited scope to prevent first-time incidence of low back pain.[50]

Specific therapies and devices intended to prevent lower back pain should be avoided, but routine aerobic exercise should be encouraged. There is some evidence to suggest that exercise alone, or in combination with education, may be effective for the prevention of lower back pain.[51][52][53][54][55]

Smoking cessation and weight control should also be considered for overall health even though these actions may not be successful with regard to primary prevention of lower back pain.

There is no, or insufficient, evidence to recommend the following interventions for the primary prevention of low back pain:[50][56][57][58]

  • Shoe insoles, lumbar support/belts, spine manipulation, and back schools

  • Training in working techniques with or without lifting equipment.

One systematic review concluded that ergonomic interventions (targeted at changing biomechanical exposure at the workplace or at changing the organization of work) are not usually effective at preventing low back pain.[59] A subsequent review and meta-analysis found that changing posture (using a sit-stand workstation) reduced the risk of developing low back pain in a sedentary population.[60]

Secondary prevention

Systematic reviews and meta-analyses indicate that exercise, with or without educational interventions, can prevent the recurrence of back pain.[54][200]​​[201]

European guidelines advocate exercise to prevent sick leave and recurrent lower back pain.[50] The guidelines further state that there is insufficient evidence to recommend for or against any specific type or intensity of exercise. The authors recommend that, once patients have recovered from acute nonspecific lower back pain, they engage in routine, low-impact aerobic exercise that includes exercises targeting core muscles.

Use of this content is subject to our disclaimer