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New WHO Guidelines Set Higher Standards for the Treatment of Back Pain

Professor Jan Hartvigsen from the University of Southern Denmark is part of the WHO working group: "In Denmark, back pain is the cause of 38% of all early retirements. Therefore, we need to upgrade our efforts for back pain – especially for the elderly."

Today, the World Health Organization (WHO) unveils a new and groundbreaking guidance on the treatment of back pain.

The guidance is based on thoroughly updated scientific syntheses and pays particular attention to a growing global challenge. As a new development, the WHO group has formulated four fundamental principles for the treatment of people with chronic back pain.

Professor Jan Hartvigsen from the University of Southern Denmark (SDU) has played a key role in developing the four new principles and corresponding recommendations for treatments. The goal has been to make the treatment guidelines more practically applicable in daily life.

Denmark does not adhere to WHO's principles

The report recommends a significantly changed approach to the treatment of chronic back pain. An approach that Denmark does not automatically comply with:

"In Denmark, we need to step up to meet the treatment principles now formulated by WHO," says Professor Jan Hartvigsen from SDU's Center for Health in Muscles and Joints at the Department of Sports Science and Biomechanics.

"For example, Danes do not have equal access to the recommended treatments, and our Danish treatment system lacks proper coordination of our efforts towards people with back pain. We cannot accept that," he adds.

WHO's guidelines emphasize four fundamental principles:

  • Holistic approach: Treatment should consider the individual's personal and social context. WHO focuses on viewing people as wholes, not just as patients with a bad back.
  • Equal access regardless of economic status and age: WHO stresses the need for equal access to treatment, especially for older people who are often overlooked and discriminated against in the healthcare system.
  • Empathetic communication: Healthcare professionals should listen, show empathy, and avoid stigmatizing language. People with back pain should be defined by what they can do rather than what they cannot.
  • Integrated and coordinated efforts: WHO encourages a coordinated approach across healthcare sectors to ensure that all relevant information about patients reaches everyone involved. This is particularly important for the elderly with multiple concurrent illnesses.

Greater focus on the elderly

The increase in the number of elderly people worldwide has prompted WHO to pay special attention to this group.
"WHO specifically focuses on older people simply because we are becoming more and more elderly globally. At the same time, the elderly often have more complex health problems than younger individuals," says Jan Hartvigsen.

"For all recommendations, we have therefore specifically assessed whether a treatment is suitable for the elderly. Research suggests that older people with chronic back pain are not offered the best treatments; one could say they are discriminated against. We need to be aware of this and address it," emphasizes Jan Hartvigsen.

Lack of research in back pain

"We evaluated a total of 37 treatments and found several where there was no research at all to help determine whether the treatment is helpful or harmful," says Jan Hartvigsen.

"Therefore, there is a need for much more research in the field, especially research that provides insights into how we best treat people with chronic back pain who also have other diseases," adds Jan Hartvigsen.

Meet the researcher

Jan Hartvigsen is professor from Center for Health in Muscles and Joints at the Department of Sports Science and Biomechanics.


About WHO's working group

The WHO report is titled "WHO Guideline for the non-surgical management of chronic primary low back pain in adults in community and primary care settings."

  •  An international expert group has spent the last 3 years collecting and analyzing the latest scientific evidence on the treatment of back pain.
  • The group consisted of 25 scientific experts, clinicians, and patients from around the world who worked together under the leadership of WHO.
  • Jan Hartvigsen is the only Dane in the group and has written the background document for the guidelines.
  • The recommendations are the first ever from WHO regarding back pain.
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