Background: For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to
better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative,
interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to
guide treatment by an integrative group of providers within a randomized controlled trial.
Methods: A clinical care pathway was used by a multidisciplinary group of providers, which included
acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary
care physicians. Treatment recommendations were based on an evidence-informed practice model, and reached
by group consensus. Research study participants were empowered to select one of the treatment
recommendations proposed by the integrative group. Common principles and benchmarks were established to
guide treatment management throughout the study.
Results: Thirteen providers representing 5 healthcare professions collaborated to provide integrative care to study
participants. On average, 3 to 4 treatment plans, each consisting of 2 to 3 modalities, were recommended to study
participants. Exercise, massage, and acupuncture were both most commonly recommended by the team and
selected by study participants. Changes to care commonly incorporated cognitive behavioral therapy into
treatment plans.
Conclusion: This clinical care pathway was a useful tool for the consistent application of evidence-based care for
low back pain in the context of an integrative setting.