Purpose Based on current scientific evidence and best practice, the first Dutch multidisciplinary practice guideline for occupational health professionals was developed to stimulate prevention and enhance work participation in patients with low back pain (LBP) and lumbosacral radicular syndrome (LRS). Methods A multidisciplinary working group with health care professionals, a patient representative and researchers developed the recommendations after systematic review of evidence about (1) Risk factors, (2) Prevention, (3) Prognostic factors and (4) Interventions. Certainty of the evidence was rated with GRADE and the Evidence to Decision (EtD) framework was used to formulate recommendations. High or moderate certainty resulted in a recommendation “to advise”, low to very low in a recommendation “to consider”, unless other factors in the framework decided differently. Results An inventory of risk factors should be considered and an assessment of prognostic factors is advised. For prevention, physical exercises and education are advised, besides application of the evidence-based practical guidelines “lifting” and “whole body vibration”. The stepped-care approach to enhance work participation starts with the advice to stay active, facilitated by informing the worker, reducing workload, an action plan and a time-contingent increase of work participation for a defined amount of hours and tasks. If work participation has not improved within 6 weeks, additional treatments should be considered based on the present risk and prognostic factors: (1) physiotherapy or exercise therapy; (2) an intensive workplace-oriented program; or (3) cognitive behavioural therapy. After 12 weeks, multi-disciplinary (occupational) rehabilitation therapy need to be considered. Conclusions Based on systematic reviews and expert consensus, the good practice recommendations in this guideline focus on enhancing work participation among workers with LBP and LRS using a stepped-care approach to complement existing guidelines focusing on recovery and daily functioning.

目的基于当前的科学证据和最佳实践，制定了第一份荷兰职业卫生专业人员多学科实践指南，以促进预防和提高腰痛 (LBP) 和腰骶神经根综合征 (LRS) 患者的工作参与度。方法一个由卫生保健专业人员、患者代表和研究人员组成的多学科工作组在对有关 (1) 危险因素、(2) 预防、(3) 预后因素和 (4) 干预措施的证据进行系统审查后制定了建议。使用 GRADE 对证据的确定性进行评级，并使用证据到决策 (EtD) 框架来制定建议。高度或中等确定性导致建议“建议”, 在“考虑”的建议中从低到非常低，除非框架中的其他因素有不同的决定。结果应考虑风险因素清单，并建议评估预后因素。为了预防，除了应用“举重”和“全身振动”等循证实用指南外，还建议进行体育锻炼和教育。提高工作参与度的阶梯式护理方法从建议保持活跃开始，通过告知工人、减少工作量、行动计划以及在规定的时间和任务中视时间增加工作参与度来促进。如果工作参与度在 6 周内没有改善，则应根据目前的风险和预后因素考虑额外的治疗：（1）物理疗法或运动疗法；(2) 以工作场所为导向的强化计划；(3) 认知行为疗法。12周后，结论基于系统评价和专家共识，本指南中的良好实践建议侧重于使用阶梯式护理方法来加强 LBP 和 LRS 工人的工作参与，以补充侧重于康复和日常功能的现有指南。