Table 1.

Comparison of Current Clinical Practices and Transformed Care Pathway for Management of Low Back Pain Care

Current Clinical Practices	Transformed Care Pathway
Before Care Seeking Limited information on evidence-based back pain prevention Pervasive biomedical perspective of pain in the public	Before Care Seeking Biopsychosocial public education efforts to understand pain Importance of physical activity for back pain prevention and self-management emphasized by health systems Incentives for engaging in preventative behaviors and activities
Care Seeking Multiple, inconsistent potential health system entry points Medical diagnosis and imaging emphasized Inconsistent decision-making on need for additional care	Care Seeking Urgent or immediate care when indicated by medical necessity Health system entry points consistently provide foundational care Self-management strategies emphasized Risk stratification and informed patient preferences guide decisions for additional care
Care Delivery Pharmacological interventions emphasized Care escalation based on provider preferences, local patterns and custom Limited planning for exit from health system Lack of preparation for self-management of recurrent episodes High rates of invasive procedures without appropriate indications Limited planning for exit from health system	Care Delivery Non-pharmacologic, physical and behavioral interventions emphasized Consideration of alternative non-pharmacologic modalities prior to escalation Links between health system and population based resources to facilitate self-management Care escalation based on risk/benefit assessment and shared decision-making Individuals receiving invasive care meet appropriateness indications