Back and Neck Pain

  • Conduct a history and physical exam for low back pain and be able to differentiate between the possible causes
  • Be familiar with the Core Back Tool and be able to use it to identify the different patterns of back pain
  • Be familiar with the Core Neck Tool and be able to use it to ask the appropriate questions on history and do a physical examination in order to make an accurate assessment
  • Recognize red flags for patients presenting with low back pain and neck pain.
  • Propose an initial management plan that includes:
    • Appropriate and timely investigation of urgent or potentially serious conditions
    • Evidence-informed management of low back and neck pain, including non-pharmacological treatment, pharmacological modalities, return to work strategies, and secondary prevention.

Core Resources

Low Back Pain Clinical Card 2014

Sherlock KM, Keegan DA.  Low Back Pain.  Canadian Family Medicine Clinical Card.  2010.  Available at: https://sites.google.com/site/sharcfm/

CEP CoreBackTool 2016

Centre for Effective Practice.  Clinically Organized Relevant Exam (CORE) Back Tool.  Published March 2016.  Available at http://thewellhealth.ca/low-back-pain

Low Back Pain

Toward Optimized Practice (TOP) Low Back Pain Working Group. 2015 December. Evidence-informed primary care management of low back pain: Clinical practice guideline. Edmonton, AB: Toward Optimized Practice. Available from: http://www.topalbertadoctors.org/cpgs/885801

CORE Neck Tool and Headache Navigator

Toronto: Centre for Effective Practice. Reprinted with Permission from Centre for Effective Practice (July 2016). CORE Neck Tool and Headache Navigator. https://thewellhealth.ca/wp-content/uploads/2016/07/CEP_HeadandNeck_2016_v15.2-1.pdf

Supplemental Resources

Diagnosis_and_management_of_low-back_pain in primary care

Traeger A, Buchbinder R, Harris I, Maher C. Diagnosis and management of low-back pain in primary care.
CMAJ Nov 2017, 189 (45) E1386-E1395; DOI: 10.1503/cmaj.170527

PEER simplified decision aid for chronic back pain treatment options in primary care

Kirkwood J et al. PEER simplified decision aid: chronic back
pain treatment options in primary care. Can Fam Physician 2021;67:31-4. DOI: 10.46747/cfp.670131

Opioid Risk Tool

Centre for Effective Practice.  Low Back Pain Strategy: Opioid Risk Tool.  Published January 2013.  Available at http://thewellhealth.ca/low-back-pain  Reprinted from Webster LR, Webster R. Predicting aberrant behaviors in Opioid-treated patients: preliminary validation of the Opioid risk tool. Pain Med. 2005;6(6):432.