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Evidence to Improve Care

Low Back Pain

Care for Adults With Acute Low Back Pain


This quality standard addresses care for those 16 years of age and older with acute low back pain, with or without leg symptoms. It examines the assessment, diagnosis, and management of people with this condition by health care professionals across all health care settings, but focuses on primary care in particular. It provides guidance on reducing unnecessary diagnostic imaging and on both nonpharmacological and pharmacological therapies.

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The guide below is in draft form. Please check back here in a few months for the finalized quality standard and a patient reference guide, along with a variety of other resources related to this standard.

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Quality Standard

If you are a health care professional: know and offer the highest quality care based on the best available evidence

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The clinical guide cover


The guide for patients is still under development. Thank you for your patience as we work to improve it.


The work on this quality standard started in May 2017.

Virtual Town Hall: November 2017

Public feedback phase: April 2018

Health Quality Ontario thanks the following individuals for their generous, voluntary contributions of time and expertise to help create this quality standard:

Julia Alleyne (Co-Chair)
Family Physician, Toronto, Rehabilitation Institute
Associate Professor, University of Toronto

Raja Rampersaud (Co-Chair)
Spinal Surgeon, University Health Network
Professor, Department of Surgery, Division of Orthopaedic Surgery, University of Toronto

Barbara Sklar
Lived Experience Advisor

Caroline Fanti
Physiotherapist and Director,
Regional Orthopedic Program, Thunder Bay Regional Health Sciences Centre

David Dos Santos
Chiropractor,
Trillium Health Partners

Deborah Kopansky-Giles
Chiropractor, St Micheal's Hospital Family Health Team
Professor, Graduate Education and Research, Canadian Memorial Chiropractic College

Eugene Wai
Spinal Surgeon, The Ottawa Hospital
Associate Professor, Department of Surgery, University of Ottawa

Jeanne Bank
Lived Experience Advisor

Jenny Tang
Lived Experience Advisor 

John F. Flannery
Medical Director,
Musculoskeletial & Multisystem Rehab Program, University Health Network - Toronto Rehab 

John Riva
Chiropractor, Assistant Clinical Professor,
Department of Family Medicine, McMaster University 

Jordan Miller
Physiotherapist, Assistant Professor,
School of Rehabilitation Therapy, Queen's University 

Karen Clayton-Roberts
Chief NP, Clinic Director,
Belleville Nurse Practitioner Led Clinic 

Paul Taenzer
Psychologist,
Independent practice 

Ravinder Ohson
Family Physician, Associate Clinical Professor,
Department of Family Medicine , McMaster University

Scott Shallow
Family Medicine resident, (PGY-2),
Queen's University

Simon French
Associate Professor,
School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University

For more information, contact QualityStandards@HQOntario.ca.

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Claude Lurette and Kowsiya Vijayartnam, Health Quality Ontario Patient, Family and Caregiver Advisors Council Co-Chairs

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