There is consensus among musculoskeletal and manual medicine experts on the limitations of current diagnostic approaches, especially imaging, which can overlook musculoskeletal dysfunctions as well as biomechanical, lifestyle and psychosocial factors, thus failing to reflect current clinical understanding. As a result, they offer limited value in distinguishing or categorizing the estimated 80% of low back pain (LBP) cases considered non-specific. The European Scientific Society of Manual Medicine (ESSOMM) [1] has initiated a new project to develop an international classification for low back pain (ICLBP), addressing limitations in current classification systems and aiming to enhance diagnostic and treatment standards globally. This new classification will incorporate recent advances in neurophysiology and functional medicine, particularly in areas such as pain modulation, motor control dysfunction, and lifestyle and psychosocial factors, to create a more comprehensive and clinically relevant framework. The ICLBP will adopt a structured approach, categorising low back pain by aetiology, pathoanatomy, clinical signs and contributing factors, thereby facilitating more precise and tailored treatment strategies. To ensure the ICLBP’s rigor and applicability, the ESSOMM will employ the Delphi method, a consensus-driven approach that gathers experts from various medical disciplines. This repetitive process, possibly guided by a Delphi specialist, will allow for continuous refinement and validation of the classification criteria, promoting an evidence-based and widely accepted framework for clinicians and researchers alike. Furthermore, the ESSOMM will maintain transparency by providing regular interim reports, fostering trust and encouraging feedback from the medical community. If successful, the ICLBP could advance the standardisation of low back pain care and improve diagnostic accuracy, treatment planning and, ultimately, patient outcomes.
