Clinical Guidelines

NASS clinical guidelines offer evidence-based recommendations addressing key clinical questions for specific diagnoses.

NASS Guidelines

NASS develops clinical practice guidelines regarding the diagnosis and treatment of spinal disorders. Guidelines are intended as educational tools for a multidisciplinary audience to improve patient care by outlining reasonable information-gathering and decision-making processes used in the management of back pain in adults. The NASS Evidence-based Guideline Development Committee is trained in evidence analysis and uses an evidence-based guideline development methodology.

Currently Under Development
Evidence-Based Guideline for the Diagnosis and Treatment of Low Back Pain Available Soon

“This is the largest clinical guideline NASS has ever undertaken,” said D. Scott Kreiner, MD, an Arizona physiatrist, co-chair of NASS’ Evidence-Based Guideline Development Committee, and NASS Research Council Director.

Eleven societies provided stakeholder representatives to assist in the development and provided comments to assist in the review of the Diagnosis and Treatment of Low Back Pain guideline. “Hundreds, if not thousands, of cumulative hours were spent by work group volunteers to develop this resource,” Kreiner stated.

This guideline provides evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of adult patients with non-specific low back pain with leg pain above the knee. The guideline is separated in the following sections:

  1. Diagnosis
  2. Imaging
  3. Medical and Psychological Treatment
  4. Physical Medicine and Rehabilitation
  5. Interventional Treatment
  6. Surgical Treatment
  7. Cost Utility

Clinical Question Protocol

Download For Free:
Diagnosis and Treatment of Adult Isthmic Spondylolisthesis

Diagnosis and Treatment of Degenerative Spondylolisthesis (Revised 2014)

Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy

Antibiotic Prophylaxis in Spine Surgery (Revised 2013)

Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis (Revised 2011)

Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders

Antithrombotic Therapies in Spine Surgery


NASS encourages widespread circulation and implementation of the evidence-based recommendations made in NASS guidelines. To this end, NASS supports responsible translation of its clinical practice guidelines into other languages. NASS strongly encourages use of appropriately trained translators with an excellent knowledge of the English language, an excellent knowledge of the target language, significant experience in both languages, cultures and medicine, and ideally some content knowledge.

It is also strongly recommended that translators implement a rigorous procedure for verifying the accuracy of translations via a multiple forward translation process or a back-translation process with careful comparisons between documents. Individuals interested in translating guidelines are granted permission to do so, provided the resulting publication follows these requirements:

  • The document carries the NASS disclaimers below
  • The document clearly indicates the version of the guideline being translated either by version number or date of publication by NASS
  • No fees are charged above those charges necessary to recoup the cost of translation.

Any translations of the NASS clinical practice guidelines should carry the following disclaimers on each page:

Translation Disclaimer:

Reprinted and translated with the permission of NASS. NASS does not verify, certify and is not responsible for the accuracy of any translations, and has advised any parties translating the NASS clinical practice guidelines to carefully verify the accuracy of their translations prior to publication and dissemination.

Clinical Guideline Disclaimer:

This clinical guideline should not be construed as including all proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment is to be made by the physician and patient in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution.

Any prospective translator must complete the clinical practice guideline translation record and send a copy to NASS to keep on file so that NASS may track translations, appropriately direct individuals to translations of interest and notify translators of content updates and revisions.