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Low Back Pain Care Pathway

Date of last update: February, 2024

Outcome Measures

Clinical Cornerstone:

  • By incorporating a meaningful set of outcome measures before treatment begins and reviewing them at regular intervals, clinicians can ensure that care remains patient-centered and evidence-driven. The plan of management can be adapted as needed to achieve the best possible results. Selected outcome measures should be congruent with the patient’s goals and expectations of treatment.

Common outcome measures for patients with LBP include:

  • Pain: Pain scales (e.g., NRS), pain diagram.

  • Goal Attainment: Help the patient to set SMART Goals: Specific, Measurable, Achievable, Relevant, Timely.

  • Return to Work/School/Activities: PSFS (Patient specific functional scale).

  • Function and participation: e.g., MYMOP, WHODAS 2.0 (12item) (WHO Disability Assessment Schedule).

  • Recovery: Self-rated recovery scales (e.g., Self-Rated Recovery Question: How well do you feel you are recovering from your condition?).

  • Self-perceived General Health: Excellent, very good, good, poor.

  • Psychosocial Assessment: Assess any psychosocial factors that may impact recovery e.g., FABQ (Fear Avoidance Behaviour Questionnaire), ORT (Opioid Risk Tool).

  • Quality of Life: e.g., SF-12 (Short-Form - 12).

  • Patient Feedback: Patient experience and satisfaction with care.

Conduct patient assessment

Red flags present

Red flags present

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Refer to appropriate emergency or healthcare provider

Non-specific LBP or LBP with radiculopathy:

  • Education

  • Self-care

  • Exercise

  • Manual therapy

  • Medicines

  • Psychological therapy

  • Social support

  • Mind-body interventions

  • Needling therapies, electrotherapies*

  • Mobility assistive devices

  • Multicomponent biopsychosocial care

  • Topical ceyenne pepper

Additionally for LBP with radiculopathy:

  • Medical/surgical consultations

Other specific LBP:

  • Refer to appropriate emergency or healthcare provider

Major symptom/sign change

Goals not achieved

Re-evaluate

Adjust treatment and management plan or refer

References or links to primary sources

Contact information for further inquiries or feedback

carolina.cancelliere@ontariotechu.ca

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.

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