Enhancing the health of Canadians by fostering excellence in chiropractic care

Guideline
Scope & Purpose
Outcomes
Care Pathways

Care Pathway for the Management of Lumbar Disc Herniation with Radiculopathy

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Does your patient have other conditions (e.g. physical or mental health conditions or co-morbidities)?

Examples include:

Headache

Physical conditions: neck pain, headache

Thinking Man on Couch

Mental health conditions: depression, anxiety

Yes
No
Diabetes Self Management Program

Co-morbidities: diabetes, heart disease

Adults with lumbar disc herniation with radiculopathy

Conduct an appropriate clinical evaluation

Risk factors for serious pathologies?

No

Other conditions?

No

Poor prognostic factors?

No

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

Yes

No

No

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

No

  1. Incomplete recovery: Initiate persistent protocol

  2. Major symptom change (new or worsening physical, mental or psychological symptoms): refer to physician

Literature search updated April 2015