Year: 2026
Type: article
Abstract: Low back pain (LBP) is one of the most frequently encountered conditions in orthopedics, physical therapy and rehabilitation, and pain medicine. Its etiology is multifactorial and its management options are diverse. However, a unified, standardized, and evidence-based clinical pathway for LBP remains lacking, leading to substantial variation in diagnostic reasoning, treatment selection, outcome assessment, and long-term care across healthcare settings and professional disciplines. To address this gap, Chinese Society for the Study of the Lumbar Spine, Chinese Association of Spine initiated this multidisciplinary expert consensus. The project was organized and implemented by Xijing Hospital of Fourth Military Medical University and Beijing Chaoyang Hospital of Capital Medical University, in collaboration with a national multicenter panel of clinical experts and methodologists. Using rigorous evidence-based methodology, the panel developed an expert consensus on recommendation levels for clinical diagnosis and treatment pathways in LBP. Comprehensive searches of multiple databases and guideline sources were performed from 1991 to December 2025 in this consensus. A total of 4 703 publications were initially retrieved, and 653 publications were ultimately selected to inform the development of the consensus statements, including 70 systematic reviews and 145 original studies that directly supported the formulation and grading of recommendations. Centered on key elements across the entire care continuum, including precise diagnostic assessment, stepwise treatment selection, multimodal comprehensive interventions, long-term outcome management, recurrence prevention, patient education, and self-management, this consensus provides a structured set of recommendations. It clarifies the core diagnostic criteria and intervention strategies for patients with low back pain caused by different etiologies, and classifies interventions as "strong recommendation", "weak recommendation", "weak recommendation against", or "strong recommendation against". The recommendations emphasize individualized and stepwise decision-making tailored to patient-specific circumstances, reaffirm the foundational role of conservative management, and define strict indications for surgery and other invasive interventions. In addition, the consensus evaluates the potential synergistic effects of combined treatment strategies and highlights the importance of recurrence prevention and functional rehabilitation in long-term care. It also provides guidance on multidisciplinary collaboration and referral criteria within the clinical pathway. Overall, this consensus aims to provide clinicians at all levels of healthcare with a clear and authoritative decision-making framework. By promoting a shift from experience-based and fragmented practice toward systematic, standardized, and evidence-based management, this consensus is expected to improve clinical outcomes, enhance patients' quality of life, and support more efficient use and distribution of healthcare resources.
Source: Bone Research
Authors: Bo Gao, Rundong Chai, Guanyi Wang, Yanfang Song, Lei Shang, Jinghui Huang, Xu Cao, Yong Hai, Zhuojing Luo, Yong Hai, Zhongqiang Chen, Shiqing Feng, Jianyuan Jiang, Fang Li, Li Li, Zhuojing Luo, Yueming Song, Zhaomin Zheng, Jun Ao, Yunbing Chang, Bohua Chen, Deyu Chen, Jianting Chen, Liang Chen, Qixin Chen, Shaoqian Cui, Shucai Deng, Huiqiang Ding, Guiyou Feng, Yanzheng Gao, Tao Guo, Zhaoqing Guo, Qing He, Baorong He, Shisheng He, Yi Hong, Zhenghua Hong, Congren Huang, Han Jiang, Dianming Jiang, Bo Li, Chunde Li, Fangcai Li, Feng Li, Ming Li, Zhongshi Li, Yu Liang, Baoge Liu, Bo Liu, Haiying Liu, Hao Liu, Hongjian Liu, Yang Liu, Yang Liu, Yuzeng Liu, Shibao Lu, Feizhou Lv, Xuexiao Ma, Haiqing Mao, Wei Mei, Zhibin Meng, Lin Nie, Baogan Peng, Qiang Qi, Bangping Qian, Longxi Ren, Dike Ruan, Zengwu Shao, Cailiang Shen, Yong Shen, Weibin Sheng, Jiangang Shi, Changtai Sun, Zhiming Sun, Xun Tang, Ye Tian, Feng Wang, Huadong Wang, Huan Wang, Peng Wang, Zhe Wang, Zili Wang, Wenwen Wu, Yongchao Wu, Zenghui Wu, Ji Wu, Chunyang Xi, Qun Xia, Jie Xiao, Zengming Xiao, Huazi Xu, Jianguang Xu, Jianzhong Xu, Jinglong Yan, Huilin Yang, Qun Yang, Zhengxu Ye, Guoyong Yin, Qiang Zhang, Wenzhi Zhang, Zhongmin Zhang, Guangmin Zhao, Jie Zhao, Changqing Zhao, Qiang Zhou, Yue Zhou, Qingsan Zhu, Yue Zhu
Institutions: Xijing Hospital, Air Force Medical University, Johns Hopkins University, Johns Hopkins Medicine, Capital Medical University, Beijing Chao-Yang Hospital, Capital Medical University, Peking University, Peking University Third Hospital, Tianjin Medical University General Hospital, Tianjin Medical University, Fudan University, Huashan Hospital, The Military General Hospital of Beijing PLA, Second Affiliated Hospital of Zhejiang University, Tongji Hospital, Huazhong University of Science and Technology, Zhejiang University, Chinese PLA General Hospital, First Affiliated Hospital of Chinese PLA General Hospital, The First Affiliated Hospital, Sun Yat-sen University, Zunyi Medical University, Guangdong Provincial People's Hospital, Qingdao University, Affiliated Hospital of Qingdao University, Shanghai Changzheng Hospital, Nanfang Hospital, Southern Medical University, First Affiliated Hospital of Soochow University, Sheng Jing Hospital, China Medical University, Tianjin Hospital, Ningxia Medical University, Ningxia Medical University General Hospital, Alice Ho Miu Ling Nethersole Hospital, Zhengzhou University, Henan Provincial People's Hospital, Guizhou Provincial People's Hospital, Peking University International Hospital, Chinese People's Liberation Army, Xi'an Honghui Hospital, Tongji University, Shanghai Tenth People's Hospital, China Rehabilitation Research Center, Zhejiang Taizhou Hospital, Tianjin Third Central Hospital, The Affiliated Yongchuan Hospital of Chongqing Medical University, Peking University First Hospital, Second Military Medical University, Changhai Hospital, China-Japan Friendship Hospital, Shanghai Jiao Tong University, Ruijin Hospital, Beijing Jishuitan Hospital, Beijing Tian Tan Hospital, Sichuan University, West China Hospital of Sichuan University, Peking University People's Hospital, First Affiliated Hospital of Zhengzhou University, First Affiliated Hospital of Dalian Medical University, Xuan Wu Hospital of the Capital Medical University, Hainan Medical University, Qilu Hospital of Shandong University, Nanjing Drum Tower Hospital, Nanjing University, Beijing Chuiyangliu Hospital, Tsinghua University, Wuhan Union Hospital, Anhui Medical University, First Affiliated Hospital of Anhui Medical University, Hebei Medical University, Third Hospital of Hebei Medical University, Xinjiang Medical University, First Affiliated Hospital of Xinjiang Medical University, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Hospital, Tianjin Huanhu Hospital, Kunming General Hospital of Chengdu Military Command, Peking Union Medical College Hospital, First Hospital of China Medical University, Sun Yat-sen University, Sun Yat-sen Memorial Hospital, Air Force General Hospital PLA, Harbin Medical University, Second Affiliated Hospital of Harbin Medical University, Logistics University of People's Armed Police Force, Chinese People's Armed Police Force, Guangxi Medical University, First Affiliated Hospital of GuangXi Medical University, Wenzhou Medical University, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Army Medical University, Southwest Hospital, Shanghai Sixth People's Hospital, Dalian Medical University, Jiangsu Province Hospital, Beijing Ditan Hospital, University of Hong Kong, Shanghai Ninth People's Hospital, Xinqiao Hospital, Jilin University
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,405
OpenAlex ID: W7204451273