Brandyn Powelske, PhD Candidate, ¹ Greg Kawchuk, ² Ted Findlay,³

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Abstract: While low back pain is one of the most common clinical conditions seen in a family physician's office, there remains a lack of low or no cost initial treatment options that are concordant with recognized best practice guidelines. As a result, many patients are offered investigations and treatments that have limited value and/or significant risks but are readily available through publicly funded provincial health care systems. GLA:D® Back builds upon the successful GLA:D model (initially developed for hip and knee osteoarthritis patients) by using the same established methodology to deliver a patient education and targeted rehabilitation program for low back pain.

Key Words: low back pain; best practice; guidelines; education; rehabilitation.

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1. Low Back Pain remains one of the most seen conditions in a family medical practice, and chronic low back pain the leading cause of ongoing disability

2. There are significant patient financial and access barriers to treatment modalities most consistently recommended in practice guidelines: education and activity/rehabilitation-based therapies.

3. GLA:D Back presents a validated option that can help close the gap between recommended treatments for low back pain and access through a primary care practice.

4. GLA:D Back is an extension of the well-recognized and widely used GLA:D program for hip and knee osteoarthritis.

In the absence of clinical "Red Flags", avoid ordering unnecessary imaging when the results are not needed for investigating an established clinical diagnosis or to initiate a therapeutic procedure.

When considering pharmacotherapeutic options, remember that the Institute for Safe Medical Practices (Canada Institute for Safe Medication Practices Canada notes that opioids should generally be avoided in the treatment of low back pain, headache and fibromyalgia.

The Covid-19 Pandemic has taught us that many group based education and rehabilitation-based programs can be effectively delivered in a virtual format.

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