Low Back Pain Information on Austrian Healthcare Websites: Often Inaccurate, Biomedically Oriented, and Not Aligned...

Low back pain (LBP) presents a substantial burden on individuals and society, with far-reaching personal, social, and economic consequences. Although the biopsychosocial model was introduced decades ago as a more holistic and human-centred framework for managing chronic pain, the biomedical model continues to dominate clinical reasoning and therapeutic strategies. The way LBP is communicated to patients significantly influences outcomes: biomedical language has been associated with increased anxiety, demand for imaging and invasive interventions, and reduced treatment efficacy. Moreover, early exposure to non-guideline-concordant treatments or unnecessary imaging in acute LBP is linked to higher risk of chronification, increased healthcare costs, greater disability, and prolonged absence from work. Given the rising use of the internet for health information, websites of official institutions-such as physiotherapy and medical practices, hospitals, national health agencies, and medical universities-play a key role in shaping patients' beliefs and behaviours.

We conducted a systematic, population-wide website content analysis in Austria to evaluate guideline adherence and the framing of LBP. Specifically, we assessed whether websites promoted guideline-concordant treatments, adopted a biomedical versus biopsychosocial perspective, and included inaccurate or misleading information.

Using the JAMA benchmark, the German national LBP guideline, and validated checklists, we analysed 125 websites. Overall, 80.2% (n = 97/121) recommended at least one non-guideline-conform treatment; 76.8% (n = 96/125) were classified as mostly inaccurate. Biomedical framing dominated with 85.6% of websites adopting this perspective.

These findings highlight widespread misinformation and a lack of evidence-based communication on LBP across official Austrian healthcare websites.