Low Back Pain Clinical Resource

Welcome to this educational resource aimed at improving your knowledge and confidence in managing the most common musckuloskeletal presentation in general practice, low back pain (LBP).

This resource provides students and clinicians with a scaffolding of knoweldge of current evidence-based recommendations for the assessment and treatment of LBP  upon which clinical skills can be built.

The aims of this resource are:

  1. Improve your knowledge of current clinical practice guidelines for managing LBP
  2. Improve your knowledge and confidence in assessing acute, sub-acute and chronic LBP presentations
  3. Provide a comprehensive summary of the literature for interventions for LBP
  4. Improve your knowledge and delivery of biopsychosocial and pain education
  5. Improve your understanding of the evidence for the use of medicines in LBP
  6. Improve your understanding of the evidence for surgical management of LBP
  7. Instill confidence in your ability to manage acute to chronic presentations of LBP following evidence based practice

In order to get the most out of this resource, head over to this 10 minute survey where you can test your knowledge of the evidence for assessing and treating LBP. This will enable you to highlight your strengths and areas for improvement prior to utilizing the resource.

The responses obtained from the survey have already guided the creation of this resource and your contribution will have a direct impact on future updates.

Now, let’s get clear on the facts on the prevalence, health and economic impact of LBP.

Given its impact, it is crucial that physiotherapists are equipped with the knowledge and skills to confidently manage this highly prevalent and burdensome condition.

Successful management of low back pain begins with understanding that the typical course of acute and chronic LBP are completely different.

Acute LBP

A ground breaking meta analysis of 126 controlled trials of non-specific back pain, concluded that it is highly likely that a majority of acute LBP cases will see improvements no matter what treatment is given [1],[2]. Certainly, serious and complex cases of LBP exist [3],[4]. However the majority of acute LBP presentations will naturally recover over time regardless of the intervention approach.

Chronic LBP

Strong evidence suggests that the prognosis of a presentation of chronic LBP is initially favorable however recurrence is high. Published data reveals that more than two-thirds of individuals who recover from an episode of chronic LBP have a relapse within 12 months from recovery [2].

Given the variability in prognosis and complexity of back pain, it is critical that physiotherapists adhere to best practice management of LBP.

This website resource focuses on the following management approaches deemed to be the most effective for all cases of LBP.

Before getting stuck into the resource…..We encourage you to test YOUR knowledge and confidence in implementing current guideline-based advice for the management of LBP in the survey below.

This will help you identify your own learning needs, knoweldge gaps and enable you to get the most out of this resource. Ultimately, helping you be a better clinician!

Test your knowledge here!

TREK education would like to thank each individual for their contribution towards the development of this resource.

Together, we can make research evidence accessible and implementable for everyone.







  • These resources are not intended to serve as a prescribed standard of medical care. 
  • Standards of care are determined on the basis of all clinical data available for an individual patient and are subject to change as scientific knowledge and technology advance and patterns of care evolve.  
  • These resources have been developed to inform practice and should be considered guidance only.  
  • Following advice on this site will not ensure a successful outcome in every patient, nor should it be construed as including all proper methods of care or excluding other acceptable methods of care aimed at the same results.  
  • The ultimate judgment regarding a particular clinical procedure or treatment plan must be made by the clinician, based on clinician experience, expertise and in light of the clinical presentation of the patient, the available evidence, available diagnostic and treatment options, and the patient’s values, expectations, and preferences.
  1. da C Menezes Costa, L., Maher, C. G., Hancock, M. J., McAuley, J. H., Herbert, R. D., & Costa, L. O. P. (2012). The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 184(11), E613-E624. doi:10.1503/cmaj.111271
  2. Maher, C., Underwood, M., & Buchbinder, R. (2017). Non-specific low back pain. The Lancet, 389(10070), 736-747. doi:10.1016/S0140-6736(16)30970-9 
  3. Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., . . . Underwood, M. (2018). What low back pain is and why we need to pay attention. Lancet, 391(10137), 2356-2367. doi:10.1016/s0140-6736(18)30480-x
  4. Henschke, N., Maher, C. G., Refshauge, K. M., Herbert, R. D., Cumming, R. G., Bleasel, J., . . . McAuley, J. H. (2009). Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arthritis Rheum, 60(10), 3072-3080. doi:10.1002/art.24853