An Update of the Low Back Pain Guideline of the German College of General Practitioners and Family Physicians

BACKGROUND: In 2003 the German College of General Practitioners and Family Physicians (DEGAM) released an evidence based guideline for managing patients with low back pain (LBP) in general practice. Due to the development of the National German guideline it was decided to extend the validity of the guideline to 2008 without formal revision. The aim of this article is to provide an overview about new insight of care and management of LBP patients in primary care. METHOD: New relevant studies were identified with a systematic literature search in the worldwide largest medical databank Medline (pubmed) limited to clinical trials on LBP in primary care from 2003-2006. Additionally new or updated reviews form the Cochrane-Library and relevant literature known to the guideline authors were incorporated in this narrative review. RESULTS: We identified 473 studies (of which 79 were deemed relevant) and 16 new or updated Cochrane reports. CONCLUSION: The key recommendations of the guideline remain unchanged. They are basically congruent with recommendations of the Drug Commission of the German Medical Assosiation and the European guidelines. Despite intensive research on low back pain scientific evidence remains partly contradictory and it seems difficult to deduct clear recommendations.