1.Cauda Equina or 2.Severe/rapidly progressing motor neurology

1
GP TRIAGE (all spinal pain)
Nerve Root Pain (upper or lower limb, and
myelopathy)
1.Cauda Equina or 2.Severe/rapidly progressing
motor neurology
Inflammatory Component suspected
Red Flags
Go to specific flowchart
Go to specific flowchart
GP investigates X-ray/bloods/MRI
Admit spinal surgeons for details see
www.sheffieldbackpain.com
Referral to Rheumatology
Excludes
Confirms
2 week/urgent referral for details see
www.sheffieldbackpain.com
Back to Triage
2
Continue
Reassess at 1-2 weeks
If gt6 weeks
Neuro. signs/severe pain-1 week wait, otherwise 2
weeks
Management by Spinal Specialist Team
Continue (with GP agreement)
Continue (with GP agreement)
to include physiotherapy, chiropractic/osteopathy
, CBT, pain clinic, occupational health, sports
injury clinic, early MRI (spinal stenosis),
yellow flag assessment, spinal injections
2 week wait
Formal progress assessment by 6 weeks
NOTE not all leg pain is nerve root pain, so not
all cases not improving will need an MRI
3
gt3/12th, or acute on chronic-consider referral
Reassess in 1-2 weeks
if paingt6 weeks
See within 2 weeks
Continue with GP approval
Management by Spinal Specialist Team
Access to physiotherapy, chiropractic/osteopathy,
CBT, Pain clinic, occupational health, sports
injury clinic, yellow flag assessment
Formal progress assessment by 6 weeks
Tolerable symptoms
Consider referral in suitable candidates