The Role of Nutrition in Low Back Pain: A Narrative Review and Clinical Implications.

Low back pain is a pervasive global public health problem. As with other chronic non-communicable diseases, dietary intervention can improve clinical outcomes and reduce health care costs. Pharmacologic and non-pharmacologic treatments are included in non-invasive treatment clinical practice guidelines. Nutrition recommendations can also be added. This review summarizes existing information on nutrition and low back pain, identifies areas for further investigation, and proposes a role for dietary recommendations in treatment and prevention from a public health and patient care perspective. Nutritional goals for decreasing low back pain include maintaining a healthy weight, following an anti-inflammatory diet, optimizing micronutrient intake, and promoting gut microbiome health. Adherence to nutrition and health recommendations is influenced by social determinants of health, including neighborhood design, structural racism, access to healthy food, socioeconomic status, and educational level. Achieving nutritional health equity must be a top priority to reduce existing health disparities. Future research on the role of nutrition in low back pain, including optimal dietary patterns, should focus on developing recommendations to be integrated into an interdisciplinary approach to low back pain.