CP - LDH_prognostic factors

Care Pathway for the Management of Lumbar Disc Herniation with Radiculopathy

Assess the prognostic factors for delayed recovery. Most patients recover from their injury. Patients with the following prognostic factors may have a higher risk for delayed recovery:

depression
passive coping strategies
job dissatisfaction
high disability levels
disputed compensation claims
somatization

Does the patient have the poor prognostic factors?

Yes

Adults with lumbar disc herniation with radiculopathy

Conduct an appropriate clinical evaluation

Risk factors for serious pathologies?

Other conditions?

Poor prognostic factors?

Offer information on nature, management, course of the back pain as a framework for initiation of a program of care

Is treatment required?

Yes

Are symptoms ≤3 months?

Yes

Management of Symptoms

Based on shared decision making between the patient and provider, any one of the following therapeutic interventions is recommended:

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Yes

Refer to appropriate services

Go to appropriate clinical care pathways and co-manage

Discharge

Are symptoms >3 months?

Refer to medical physician for consideration of further investigation of the neurological deficits

Yes

Adjust modifiable prognostic factors

Yes

Is the person recovered after 3 months?

Yes

Discharge

Literature search updated April 2015

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Care Pathway for the Management of Lumbar Disc Herniation with Radiculopathy