Figure 3.

Overview of the integrated sequenced-care pathway for low back pain.

1. Participants are referred from a physician to central delivery to explain the Integrated Sequenced Care Pathway; initiate on-site physical therapy services; and receive an examination, on-site treatment, and a transcutaneous electrical nerve stimulation (TENS) unit.

2. Participants are referred for approximately 6 weeks of centrally delivered physical activity instruction.

3. Participants follow up with Department of Veterans Affairs (VA) physical therapy services for reexamination.

4. Participants complete the STarT Back Screening Tool (SBST). Patients who are considered “low risk” are discharged to home with instructions to continue their physical activity program. Patients who are considered “medium to high risk” are referred for approximately 6 weeks of a centrally delivered, psychologically informed intervention.

5. Participants who receive psychologically informed interventions are discharged to home upon completion.