Table 1 Target clinical behaviours

 1. Perform assessment and diagnostic triage

Assessed in-clinic by conducting a focused history and physical exam (including assessing for red flags (alerting features)) suggesting specific pathology, neurological tests for radicular syndromes, and assessment of yellow flags (presence of psychosocial risk factors). Then, exclude non-spinal pain causes (e.g. hip pathology, vascular causes); and provide a diagnosis of: specific pathology (e.g. fracture, infection, cauda equina), radicular syndrome (e.g. spinal stenosis or radiculopathy) or non-specific LBP (e.g. presumed lumbar musculoskeletal origin with no tests to specify pathoanatomical pain source)

 2. Provide patient education

Provide advice on self-management strategies with education about their condition and the associated harms of bed rest and benefits of remaining active with staged resumption of normal activities where necessary.

 3. Provide simple analgesics

Start with simple analgesics. Use non-steroidal anti-inflammatory medications for a short time after consideration of side effects and avoid opiates.

 4. Only image in those with suspected spinal pathology

Imaging should only be used when a thorough patient history and physical exam indicate a serious specific cause for LBP. Do not order imaging for patients with non-specific LBP.

 5. Referral to adjunct treatments or specialists

Referral to evidence-based adjunct conservative therapies such as physiotherapy for supervised exercise or pain management for more detailed education on pain management strategies and a goal-oriented plan of care. Referrals to specialists for surgical consultations should be reserved for those who continue to have radicular symptoms at 12 weeks and do not respond to conservative care, in which case surgery may be considered a possible treatment.