Does spinal pain management account for the presence of other health conditions?–A scoping review

Objective
This scoping review aimed to map existing literature and whether clinical guidelines recommend taking other health conditions into consideration in spinal pain management.

Method
Systematic searches covered PubMed, CINAHL, Embase, PsycINFO, and the Cochrane Library, alongside free-text online searches for clinical practice guidelines on spinal pain. Eligibility criteria encompassed studies on spinal pain with one or more chronic conditions. Study design, population, aim, outcome measurements, and findings of the included studies were summarised. Included studies were assessed for risk of bias and quality. Clinical practice guideline recommendations regarding multimorbidity were summarised.

Results
The review included five studies. One study showed that addressing other health conditions in spinal pain management improved psychological comorbidities, pain, and disability. The other studies showed no consistent additional benefits but suggested a trend towards improved pain-related disability. Analysis of 23 clinical practice guidelines revealed minimal consideration of other health conditions in spinal pain management.

Conclusions
The sparse literature and limited consideration challenge clinical practice, where spinal pain often occurs in parallel with other health conditions, leaving healthcare providers with limited guidance. This review highlights the need for more research to inform future clinical guidelines for spinal pain in patients with other concurrent health conditions.