{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:56:35Z","timestamp":1790909795244,"version":"4.1.0"},"reference-count":138,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Elsevier Ltd. and the Health Holding Company","award":["TKM-02486"],"award-info":[{"award-number":["TKM-02486"]}]},{"DOI":"10.13039\/100019281","name":"Saudi Spine Society","doi-asserted-by":"crossref","award":["SSS-04-12-2025"],"award-info":[{"award-number":["SSS-04-12-2025"]}],"id":[{"id":"10.13039\/100019281","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Low back pain (LBP) is the leading cause of disability in Saudi Arabia and contributes substantially to healthcare utilisation, reduced quality of life, and lost productivity. This guideline provides nationally standardised, evidence-based recommendations for the assessment and management of non-specific LBP and sciatica in adults, adapted to the clinical and health-system context in Saudi Arabia. Methods: A multidisciplinary Task Force developed the guideline using the GRADE ADOLOPMENT approach, using NICE guideline NG59 as the primary evidence source. One additional clinical question was formulated to address pain neuroscience education, informed by a relevant systematic review. Update literature searches were conducted in PubMed, Embase, and the Cochrane Library (2016\u20132022). The evidence was appraised using GRADE, and recommendations were formulated through structured Evidence-to-Decision deliberations and consensus voting. Results: The Task Force addressed eleven clinical questions in this guideline. Strong recommendations were provided for the use of validated risk assessment tools (very low certainty of evidence) and stratified management (moderate certainty of evidence). Conditional recommendations were made for indications for imaging, pharmacological treatment for sciatica, psychological interventions, multidisciplinary return to work programmes, epidural injections, prognostic value of image-concordant pathology, spinal decompression, radiofrequency denervation, and pain neuroscience education, with certainty of evidence ranging from very low to low. Conclusions: The findings indicate that management of non-specific LBP and sciatica in Saudi Arabia should be guided by clinical assessment, with restricted use of imaging, careful selection of pharmacological treatments, and appropriate use of psychological, multidisciplinary, and procedural interventions.<\/jats:p>","DOI":"10.3390\/jcm15020528","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T08:09:06Z","timestamp":1767946146000},"page":"528","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Saudi Clinical Practice Guideline for the Assessment and Management of Low Back Pain and Sciatica in Adults"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5375-0583","authenticated-orcid":false,"given":"Mai","family":"Aldera","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Health Sciences, College of Applied Medical Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Alturkistany","sequence":"additional","affiliation":[{"name":"Orthopedic Section, Department of Surgery, King Faisal Specialist and Research Center, Jeddah 21499, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Al Rayes","sequence":"additional","affiliation":[{"name":"Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Rada","sequence":"additional","affiliation":[{"name":"Epistemonikos Foundation, Santiago 7510321, Chile"},{"name":"Facultad de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 7820436, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9861-7828","authenticated-orcid":false,"given":"Hani H.","family":"Alsulaimany","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, King Abdulaziz Medical City, National Guard, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8366-5555","authenticated-orcid":false,"given":"Hana I.","family":"Alsobayel","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Health Sciences, College of Applied Medical Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Al-Noor Specialist Hospital, Mecca 24241, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-8195","authenticated-orcid":false,"given":"Waleed","family":"Awwad","sequence":"additional","affiliation":[{"name":"King Saud University Medical City, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7933-1894","authenticated-orcid":false,"given":"Omar A.","family":"Alyamani","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Faisal Specialist Hospital and Research Centre, Riyadh 12713, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bedaiwi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Dr Sulaiman AlHabib Medical Centers, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Almaghlouth","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami M.","family":"Bahlas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Rheumatology, King Abdulaziz University, Jeddah 22254, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour S.","family":"Alazmi","sequence":"additional","affiliation":[{"name":"Prince Mohammed Medical City, Aljouf 72346, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Brunnhuber","sequence":"additional","affiliation":[{"name":"Clinical Solutions, Elsevier Limited, London EC2Y 5AS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alhelal","sequence":"additional","affiliation":[{"name":"Spine Surgery, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0294-9856","authenticated-orcid":false,"given":"Mansour Abdullah","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca 24382, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Low Back Pain Collaborators 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