Low back pain affects around 540 million people worldwide, however the condition is often mistreated, new research has shown.

Low back pain is the leading cause of disability around the world. It mostly affects adults of working age and a specific cause is rarely identified. While many episodes are short-term, recurring back pain is common, with about one-third of those affected experiencing a recurrence within one year of a previous episode.

However, according to international researchers who wrote a series of articles on this topic, many patients are not receiving the right care and are instead being recommended inappropriate tests and treatments, including the use of opioids and surgery.

The evidence suggests that low back pain should be managed in primary (GP) care, and the first line of treatment should be education and advice to keep working and keep active.

However, the reality is that many people are treated in Emergency Departments (EDs) and are encouraged to stop working and rest. They are also commonly referred for scans or surgery, and are prescribed opioids, which are often not appropriate.

"The majority of cases of low back pain respond to simple physical and psychological therapies that keep people active and enable them to stay at work. Often, however, it is more aggressive treatments of dubious benefit that are promoted and reimbursed," commented series author, Prof Rachelle Buchbinder, of Monash University in Australia.

The researchers noted that in many countries, painkillers have ‘limited positive effect' and yet are routinely prescribed for this condition. There is also very little emphasis on evidence-based interventions, such as certain exercises.

They suggested that widespread misconceptions about the causes, prognosis and effectiveness of different treatments for low back pain must be addressed, among both members of the public and healthcare professionals.

"Millions of people across the world are getting the wrong care for low back pain. Protection of the public from unproven or harmful approaches to managing low back pain requires that governments and healthcare leaders tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo," commented series author, Prof Jan Hartvigsen, of the University of Southern Denmark.

The series of articles on low back pain is published in the medical journal, The Lancet.