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Recommendations for shaping the future of low back pain prevention research
  1. Giovanni Ferreira1,
  2. Mark Hancock2
  1. 1 Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  2. 2 Discipline of Physiotherapy, Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  1. Correspondence to Dr Giovanni Ferreira, Institute for Musculoskeletal Health, The University of Sydney School of Public Health, Sydney, New South Wales M179, Australia; giovanni.ferreira{at}

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Prevention is a fundamental tenet of medicine but has been largely ignored in low back pain (LBP), where clinical care and research have focused on the treatment of those currently experiencing an episode of LBP. For example, while a recent review of LBP prevention included 40 trials,1 there are several thousand trials evaluating treatments for LBP. Clinical practice guidelines are largely silent on the issue of prevention of LBP, providing little guidance to clinicians.

It is now recognised that LBP is typically an episodic condition, with many people having a symptom trajectory that includes periods of recovery interspersed with frequent recurrences or ongoing low levels of pain with flare-ups.2 Much of the LBP burden, therefore, results from recurrences and flare-ups. Given this, we believe that the rationale and evidence for a greater focus on secondary or tertiary prevention are overwhelming. In this editorial, we outline recommendations for shaping future LBP prevention research to ensure the best use of research resources.

Prevention efforts should focus on secondary and tertiary prevention

Preventing a first-ever LBP episode …

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  • Contributors Both authors contributed equally to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.