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
-
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
Signs or Symptoms of Pathology (Red Flags)
Clinical Cornerstone: Consider asking additional questions that help evaluate for the presence of red flags in low back pain. Red flags are symptoms or signs that may indicate a serious pathology and should be deliberated in the clinician’s differential diagnosis.
-
Spinal fracture
-
Red flags: history of osteoporosis, corticosteroid use, severe trauma, female sex, older age, history of spinal fracture, history of cancer, history of falls.
-
Action: Refer to appropriate provider for imaging especially if pain is sudden in onset and pain is severe.
-
-
Spinal malignancy
-
Red flags: history of cancer, unexplained weight loss, unexplained significant night sweats, pain worse at night.
-
Action: Refer to an appropriate provider.
-
-
Spinal infection
-
Red flags: intravenous drug use, poor living conditions, immunosuppression, recent surgery/invasive interventions, history of TB (tuberculosis)/born in TB-endemic country, recent infection, unexplained constitutional symptoms (e.g., fever/chills).
-
Action: Immediate referral to emergency care.
-
-
Cauda equina syndrome
-
Red flags: saddle anesthesia, bladder/bowel dysfunction, bilateral radicular signs.
-
Action: Immediate referral to emergency care.
-
-
Neurological disorders
-
Red flags: upper/lower motor neuron findings, clonus.
-
Action: Refer to appropriate provider.
-
Orange Flags
Clinical Cornerstone: Orange Flags are symptoms or signs that may represent the presence of serious psychiatric disorder (e.g., major depression, major personality disorders, post-traumatic stress disorders [PTSD], substance addiction and abuse). In the event such disorders are present, referral to a psychiatric specialist would be indicated over usual care in the presence of non-major disorders such as anxiety. Screening can include:
-
High level of distress, Substance addiction or abuse
Conduct patient assessment
click to learn more
Red flags present
Red flags present
Refer to appropriate emergency or healthcare provider
Diagnosis
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
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
-
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.