Sequenced Care Pathway vs Pain Navigator Pathway for Veterans With Low Back Pain

Is a sequenced care pathway superior to a pain navigation care pathway for improving pain interference and physical function outcomes for individuals seeking primary care for low back pain?In this cluster randomized clinical trial investigating the effectiveness of different nondrug care pathways in 1817 participants, the 3-month differences in improvements (sequenced care vs navigated care) in pain interference (−0.6 points) and physical function (0.6 points) were not statistically significant.This trial suggests no advantage of a sequenced care pathway vs a care pathway that navigates individuals with low back pain to commonly used nondrug treatments (eg, physical therapy, yoga, tai chi, chiropractic, or acupuncture).

Corresponding Author: Steven Z. George, PhD, Duke Clinical Research Institute, Department of Orthopaedic Surgery, 300 W Morgan St, Duke University, Durham, NC 27701 (steven.george@duke.edu).

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