The chapter provides an overview of the European guidelines for the management of chronic nonspecific low back pain (CLBP). The guidelines aim to support national and international guidelines by offering evidence-based recommendations for treating CLBP. Key objectives include fostering a realistic approach to improving treatment, ensuring an evidence-based approach, and promoting multidisciplinary collaboration. The target population includes healthcare providers, patients, and policymakers. The guidelines cover various aspects of diagnosis and treatment, including patient assessment, imaging, electromyography, and prognostic factors. They recommend specific treatments such as physical therapy, exercise therapy, manual therapy, cognitive-behavioural therapy, multidisciplinary interventions, and pharmacological approaches. The guidelines also address invasive procedures and surgery, providing recommendations based on the available evidence. Key recommendations include: - Supervised exercise therapy as a first-line treatment. - Consideration of multidisciplinary biopsychosocial rehabilitation for patients who have failed monodisciplinary treatment. - Use of noradrenergic or noradrenergic-serotonergic antidepressants for pain relief. - Use of weak opioids for short-term pain relief in patients who do not respond to other treatments. - Avoiding the use of acupuncture, epidural corticosteroids, intraarticular injections, intradiscal injections, and other invasive procedures without strong evidence of effectiveness. The guidelines emphasize the need for further research in several areas, including the effectiveness of specific exercise types, the role of cognitive-behavioural principles in treatment, and the long-term use of NSAIDs and muscle relaxants. They also highlight the importance of considering patient preferences, organizational obstacles, and cost implications in guideline implementation.The chapter provides an overview of the European guidelines for the management of chronic nonspecific low back pain (CLBP). The guidelines aim to support national and international guidelines by offering evidence-based recommendations for treating CLBP. Key objectives include fostering a realistic approach to improving treatment, ensuring an evidence-based approach, and promoting multidisciplinary collaboration. The target population includes healthcare providers, patients, and policymakers. The guidelines cover various aspects of diagnosis and treatment, including patient assessment, imaging, electromyography, and prognostic factors. They recommend specific treatments such as physical therapy, exercise therapy, manual therapy, cognitive-behavioural therapy, multidisciplinary interventions, and pharmacological approaches. The guidelines also address invasive procedures and surgery, providing recommendations based on the available evidence. Key recommendations include: - Supervised exercise therapy as a first-line treatment. - Consideration of multidisciplinary biopsychosocial rehabilitation for patients who have failed monodisciplinary treatment. - Use of noradrenergic or noradrenergic-serotonergic antidepressants for pain relief. - Use of weak opioids for short-term pain relief in patients who do not respond to other treatments. - Avoiding the use of acupuncture, epidural corticosteroids, intraarticular injections, intradiscal injections, and other invasive procedures without strong evidence of effectiveness. The guidelines emphasize the need for further research in several areas, including the effectiveness of specific exercise types, the role of cognitive-behavioural principles in treatment, and the long-term use of NSAIDs and muscle relaxants. They also highlight the importance of considering patient preferences, organizational obstacles, and cost implications in guideline implementation.