New WHO Guidelines for Low Back Pain: A StrongPosture® Win

Have you seen the new World Health Organization (WHO) guidelines for low back pain? 

In a word, WOW!

WHO experts from multiple professions did an exhaustive, 244-page guideline on 37 chronic low back pain therapies, and their conclusions are a strong validation of the work we’ve taught for the past 20 years! 

I’m really excited because our StrongPosture® method integrates 3 of the five classes of therapies recommended for routine chronic low back pain care by WHO.

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The WHO Recommendations on 5 Classes of cLBP Interventions

Class A:  Education         

Structured and standardized education and/or advice

         StrongPosture® interactive demos and our 5 Posture Principles were designed to standardize self-care communications in my NMS practice.   Instead of focusing people cognitively about pain science, we connect people to somatically feel and understand their body’s biomechanics.

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Class B:  Physical interventions

  i. Structured exercise therapies or programs

         StrongPosture® BAM (Balance-Alignment-Motion) exercises direct biomechanic understanding to successful actions people can feel.

ii Spinal manipulation

iii Massage

iv Needling

iv Mobility assistive products.

     StrongPosture® protocols were initially designed to optimize the benefits of spinal manipulation and massage.

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Class C: Psychological interventions

i. Operant therapy

ii. Cognitive behavioral therapy

         StrongPosture® protocols focus mental attention on subtleties of body motion with MUST vs TRY cueing.  So, while not mentioned by name, focusing attention on more accurate control has been described as SOMATIC behavioral therapy. Clearly defined and structured external feedback that’s individualized to each person’s functional ability to understand and execute is why clinicians globally use our integration of education, exercise and protocoled engagement.

While valuable in some cases, I agree with WHO that Class D & E should be last on the list for routine care.

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Class D: Medicines  

                    Recommended for routine care: NSAIDs & topicals. 

                    Not recommended: Opioids to muscle relaxers, oral and injectables, and some herbals

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Class E: Multicomponent Biopsychosocial Care

Generally delivered by multiple professionals in a hospital or group interdisciplinary practice.

         We integrate the essentials targeted by WHO – Educational concepts blended into individualized exercise, standardized, and structured into a step-by-step framework.  The StrongPosture® work I’ve taught around the world and on CEsoup.com online, for home care with 7 Steps to StrongPosture® on StrongPosture.com, the CPEP® certification program, as well as the public health program and May’s campaign from PostureMonth.org.

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Integrate StrongPosture® as an Intervention in Your Practice

i Begin with Posture and Balance Assessment, Rehabilitation, and Motor Control Exercise presented on CEsoup.com. A comprehensive 15-hour CE approved online program.

ii Read: Stand Taller Live Longer: Posture & Anti-Aging Strategy, including the 5 Posture Principles

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RESOURCES

For more on the WHO report on Chronic Low Back Pain see: Summary: WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings

World Health Organization Chronic Low Back Pain overview, see the Executive Summary.

If you want to dive deep, see: https://www.who.int/publications/i/item/9789240081789

To see WHAT 37 interventions were looked at, read:  https://iris.who.int/bitstream/handle/10665/374422/9789240085718-eng.pdf

For HOW it was looked at, see: https://iris.who.int/bitstream/handle/10665/374420/9789240085701-eng.pdf\