SPECIAL ARTICLE  LOW BACK PAIN UPDATE AND THE BELGIAN EXAMPLE Free access

European Journal of Physical and Rehabilitation Medicine 2020 April;56(2):220-7

DOI: 10.23736/S1973-9087.19.05983-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The Belgian national guideline on low back pain and radicular pain: key roles for rehabilitation, assessment of rehabilitation potential and the PRM specialist

Peter van WAMBEKE ¹ ✉, Anja DESOMER ², Pascale JONCKHEER ², Bart DEPREITERE ³

¹ Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium; ² Belgian Health Care Knowledge Centre, Brussels, Belgium; ³ Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium

Low back pain (LBP) and radicular pain are very common health problems. They are rarely caused by serious underlying pathology and will usually recover spontaneously in time. In about one third of the cases however, the pain and functional impairment will persist one year after onset, being responsible for high health care costs and work absence. The management of LBP and radicular pain should focus therefore on excluding signs and symptoms of serious underlying pathology, on an active approach and on the prevention of chronicity. In 2017 the Belgian Health Care Knowledge Centre (KCE) published a guideline on LBP and radicular pain. This guideline formed the basis for a national pathway on LBP and radicular pain and is the first step to change and optimize our daily clinical practice. In this Belgian guideline the importance is stressed of a comprehensive clinical assessment and a tailored rehabilitation. Pharmacological and invasive treatments have a more doubtful effect or should only be considered under certain conditions. Implementing these recommendations in an interdisciplinary pathway necessitates a central role for Physical and Rehabilitation Medicine (PRM) especially in giving advice on and/or coordinating the tailored rehabilitation to prevent chronicity. To do this, the PRM specialist should perform a medical and functional assessment according to the ICF framework and taking into account the risk for chronicity or persistent impairment and the rehabilitation potential.

KEY WORDS: Low back pain; Guideline; Rehabilitation