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Evidence-Based Diagnosis and Clinical Management of Low Back Pain
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Evidence-Based Diagnosis and Clinical Management of Low Back Pain

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1461

Special Issue Editors

Dr. William J. Hanney

E-Mail Website
Guest Editor
School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
Interests: low back pain; manual therapy; neck pain; functional exercise; patient outcomes
Dr. Michael Masaracchio

E-Mail Website
Guest Editor
Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
Interests: physical therapy; systematic reviews; health services research; manual therapy; thoracic spine manipulation

Special Issue Information

Dear Colleagues,

Low back pain (LBP) is the leading cause of years lived with disability in most countries, with many individuals experiencing chronic symptoms. It is expected that the disability burden and related costs associated with managing LBP will continue to increase over the next several decades. Research has demonstrated that rehabilitation is a cost-effective management strategy for individuals with LBP that has demonstrated decreased downstream healthcare costs and utilization. This is particularly true when rehabilitation services are initiated early and focus on risk-stratification models that predict patient chronicity, thereby assisting clinicians in clinical decision making that maximizes current resource availability. In this Special Issue, authors are invited to submit original research articles; clinical commentaries; and systematic/scoping reviews on the clinical diagnosis, classification or management of individuals with LBP. Prospective longitudinal cohort studies assessing epidemiology or predictors of LBP chronicity are also welcome. A secondary aim is to highlight health-service research related to the timing and sequencing of the clinical management of LBP.

Dr. William J. Hanney
Dr. Michael Masaracchio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • low back pain
  • classification systems
  • risk stratification
  • health services research
  • management strategies
  • timing and sequencing
  • prognosis
  • predictor
  • clinical decision making
  • primary care

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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13 pages, 274 KB  
Article
Testing the Association Between Low Back Pain Intensity and Core Muscle Strength in Postpartum Women with Different Delivery Modes: An Analytical Cross-Sectional Study
by Mohamed G. Ali, Amel M. Yousef, Mohammed A. M. Sarhan, Reem M. Alwhaibi, Hoda M. Zakaria, Abeer A. Mohammed, Walaa M. Ragab, Rehab S. Mamoon and Mohammad Auais
J. Clin. Med. 2025, 14(18), 6505; https://doi.org/10.3390/jcm14186505 - 16 Sep 2025
Viewed by 303
Abstract
Background/Objectives: Postpartum women frequently experience nonspecific low back pain (NSLBP), yet the impact of delivery mode on the function of local core muscles, particularly the transversus abdominis (TrA) and lumbar multifidus (LM), is not well understood, limiting the development of targeted rehabilitation [...] Read more.
Background/Objectives: Postpartum women frequently experience nonspecific low back pain (NSLBP), yet the impact of delivery mode on the function of local core muscles, particularly the transversus abdominis (TrA) and lumbar multifidus (LM), is not well understood, limiting the development of targeted rehabilitation strategies. To compare NSLBP intensity and TrA and LM strength in women who underwent cesarean delivery (CD) or vaginal delivery (VD), and to examine the associations between pain intensity and muscle strength. Methods: An analytical cross-sectional study was conducted on 36 women divided into two groups: 18 who underwent CD (Group A) and 18 who underwent VD (Group B). NSLBP intensity was assessed using the visual analogue scale, while TrA and LM strength were measured via a pressure biofeedback unit. Results: The two groups showed non-significant differences in age (p = 0.342), BMI (p = 0.429), or parity (p = 0.894), confirming comparable baseline characteristics. NSLBP intensity was significantly higher in the CD group (p = 0.000), and they exhibited weaker TrA (p = 0.009) strength than the VD group; however, there was a non-significant difference in LM strength (p = 0.602). The Spearman correlation analysis revealed non-significant associations between NSLBP intensity and TrA and LM strength in the CD group (p = 0.702, 0.129, respectively) and in the VD group (p = 0.149, 0.877, respectively). Conclusions: Women undergoing CD experienced higher NSLBP intensities and weaker TrA strength than those undergoing VD, while LM strength remained similar between groups. However, NSLBP intensity showed non-significant associations with TrA or LM strength in either group, suggesting that other biomechanical or neuromuscular factors may contribute to the increased post-CD NSLBP. These findings highlight the need for targeted rehabilitation strategies beyond core muscle strengthening alone. Full article
(This article belongs to the Special Issue Evidence-Based Diagnosis and Clinical Management of Low Back Pain)

Review

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12 pages, 727 KB  
Review
Evidence of Multifidus Changes Post-Lumbar Radiofrequency Ablation: A Narrative Literature Review
by Abigail Joy Garcia, David W. Lee, Logan Leavitt and Vinicius Tieppo Francio
J. Clin. Med. 2025, 14(18), 6462; https://doi.org/10.3390/jcm14186462 - 13 Sep 2025
Viewed by 736
Abstract
Background/Objectives: Chronic low back pain (CLBP) is a leading cause of disability worldwide, with lumbar medial branch radiofrequency ablation (LRFA) widely used to manage facet-mediated pain; however, emerging evidence raises concerns regarding its potential to denervate the multifidus muscle—an essential stabilizer of [...] Read more.
Background/Objectives: Chronic low back pain (CLBP) is a leading cause of disability worldwide, with lumbar medial branch radiofrequency ablation (LRFA) widely used to manage facet-mediated pain; however, emerging evidence raises concerns regarding its potential to denervate the multifidus muscle—an essential stabilizer of the lumbar spine—thereby exacerbating dysfunction. This narrative review synthesizes current evidence on multifidus atrophy and dysfunction following LRFA, emphasizes its clinical significance, and highlights gaps that warrant further research and therapeutic development. Methods: A comprehensive literature search was conducted using SANRA criteria across the Cochrane Library, Web of Science Core Collection, Scopus, PubMed, and MEDLINE. Studies assessing multifidus morphology or function after LRFA were identified and analyzed. Data were extracted from studies meeting predefined inclusion criteria. The narrative synthesis included a thematic analysis and interpretive integration focusing on clinical practice. Results: Six eligible studies were identified, five cohort studies and one case series. Of these, two confirmed decreased multifidus function post-LRFA. Four studies analyzed post-LRFA structural changes, two of which reported reduced cross-sectional area/fatty infiltration, one no measurable difference, and another an apparent enlargement. The findings are constrained by substantial differences in study design, patient populations, and outcome measures, which limit the ability to establish consistent conclusions. Conclusions: Current evidence suggests that LRFA may lead to structural and functional changes in the multifidus muscle, although findings remain inconsistent due to significant study heterogeneity. Further high-quality, prospective research with standardized imaging and functional assessments is needed to clarify the long-term clinical impact. Full article
(This article belongs to the Special Issue Evidence-Based Diagnosis and Clinical Management of Low Back Pain)
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