CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
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understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Low Back Pain Care Pathway
Date of last update: February, 2024
Diagnosis
Clinical Cornerstone:
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Diagnosing LBP requires a patient-centered approach that integrates physical, psychological, and social aspects of pain. A comprehensive diagnostic strategy integrates clinical findings with patient narratives and risk factor evaluations for a complete understanding of the patient's condition.
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LBP is broadly categorized as either non-specific, where pain or symptomology is not attributed to a distinct pathology like disease or tissue damage, or specific, where it is linked to an underlying condition (e.g., cancer, fracture) or referred from other organs. Lumbar disc herniation causing LBP with radiculopathy, is a common specific cause. Further diagnostic testing is usually required to confirm a specific diagnosis of LBP.
Differential Diagnosis for Low Back Pain
1. Non-specific Low Back Pain
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Lumbar or lumbo-sacral strain/sprain
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Degenerative changes/osteoarthritis (e.g., degenerative disc disease, facet arthropathy)
2. Specific Low Back Pain
a) Low Back Pain with Radiculopathy:
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Herniated nucleus pulposus (disc protrusion or herniation causing nerve root compression)
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Spinal stenosis (narrowing of the spinal canal leading to nerve compression)
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Piriformis syndrome
b) Fracture:
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Vertebral fracture, including compression fracture from osteoporosis
c) Inflammatory and Infectious Causes:
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Ankylosing spondylitis
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Osteomyelitis (bone infection)
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Discitis (intervertebral disc infection)
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Epidural abscess
d) Neoplastic Causes:
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Primary spinal tumors
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Metastatic spinal tumors
e) Referred Pain:
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Hip pathology (e.g., hip osteoarthritis, labral tears)
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Visceral abdominal conditions (e.g., aortic aneurysm, endometriosis, tubal pregnancy, kidney stones, pancreatitis)
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Pelvic conditions (e.g., prostatitis, pelvic inflammatory disease)
f) Neurological Causes:
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Peripheral neuropathy (e.g., diabetic neuropathy)
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Cauda equina syndrome
g) Other Causes:
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Trauma or minor trauma leading to injuries
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Pregnancy-related back pain
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Fibromyalgia
Conduct patient assessment
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Red flags present
Red flags present
Refer to appropriate emergency or healthcare provider
Diagnosis
Non-specific LBP or LBP with radiculopathy:
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Education
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Self-care
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Exercise
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Manual therapy
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Medicines
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Psychological therapy
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Social support
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Mind-body interventions
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Needling therapies, electrotherapies*
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Mobility assistive devices
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Multicomponent biopsychosocial care
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Topical ceyenne pepper
Additionally for LBP with radiculopathy:
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Medical/surgical consultations
Other specific LBP:
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Refer to appropriate emergency or healthcare provider
Follow-up
Follow-up
Major symptom/sign change
Goals not achieved
Re-evaluate
Adjust treatment and management plan or refer
References or links to primary sources
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Wong, J.J., Côté, P., Sutton, D.A., Randhawa, K., Yu, H., Varatharajan, S., Goldgrub, R., Nordin, M., Gross, D.P., Shearer, H.M., Carroll, L.J., Stern, P.J., Ameis, A., Southerst, D., Mior, S., Stupar, M., Varatharajan, T. and Taylor-Vaisey, A. (2017), Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain, 21: 201-216. https://doi.org/10.1002/ejp.931
Contact information for further inquiries or feedback
Disclaimer:
These care pathways are intended to provide information to practitioners who provide care to people with musculoskeletal conditions. The care pathways on this website are 'living' documents, reflecting the state of clinical practice and research evidence to our best knowledge at the time of development. As knowledge and healthcare practices evolve, these pathways may be updated to ensure they remain current and evidence driven. These pathways are not intended to replace advice from a qualified healthcare provider.