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Low Back Pain: A Review
Aidan G Cashin1,2, Roger Chou3, Melissa B Weimer4,5
1School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
JAMA
|June 15, 2026
Summary
Low back pain affects millions globally and is a leading cause of disability. While acute cases often resolve, chronic low back pain requires targeted exercise, psychological therapies, and multidisciplinary care for better outcomes.
Area of Science:
- Orthopedics
- Pain Management
- Public Health
Background:
- Low back pain (LBP) impacts 619 million people globally, representing the primary cause of years lived with disability.
- Nonspecific LBP, defined as pain without identifiable spinal pathology, constitutes approximately 90% of clinical presentations.
- Prevalence is higher in females and increases with age, peaking around 85 years, with risk factors including obesity, depression, and occupational exposures.
Purpose of the Study:
- To define low back pain and its global impact.
- To outline the classification, prevalence, risk factors, and prognosis of low back pain.
- To detail recommended management strategies for acute and chronic nonspecific low back pain.
Main Methods:
- Literature review and synthesis of epidemiological data on low back pain prevalence and disability.
- Analysis of risk factors associated with low back pain development and persistence.
- Summary of current clinical guidelines for the management of acute and chronic nonspecific low back pain.
Main Results:
- Low back pain is a major global health issue, particularly nonspecific LBP which affects a large proportion of the population.
- Acute nonspecific LBP generally has a self-limited course with good recovery rates, while chronic nonspecific LBP presents a less favorable prognosis.
- Risk factors identified include obesity, depressive symptoms, occupational exposures, tobacco use, and diabetes.
Conclusions:
- Initial management for all LBP involves reassurance, education on recovery timelines, and encouragement of physical activity.
- First-line treatments for acute nonspecific LBP include heat, spinal manipulation, massage, acupuncture, NSAIDs, and muscle relaxants.
- First-line treatments for chronic nonspecific LBP emphasize exercise, psychological therapies, and multidisciplinary care, with NSAIDs as a second-line option.
