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JULY 21, 2016

Chronic Pain: tools for primary care

Various health care initiatives have been undertaken in Ontario to improve care for patients suffering from chronic pain to ensure they receive appropriate treatment, diagnostic testing and medication. According to the Ontario Government, one in five

Ontarians suffer from moderate to severe chronic pain daily or most days of the week.

Neck and Head Pain

Neck and Head Pain

Primary care providers know first-hand the challenges associated with treating headache and neck pain, especially when presented together. The CORE Neck Tool and Headache Navigator was developed to assist primary care providers in differentiating and assessing neck pain and headache.

Because neck pain and headache often have overlapping presentation of symptoms, this tool uses discrete approaches that help rule out other underlying conditions.

The Clinically Organized Relevant Exam (CORE) Neck Tool guides providers to recognize common mechanical neck pain and screen for other conditions. The CORE Neck Tool has been divided into four components:

  1. History
  2. Physical Examination
  3. Management Matrix
  4. Referrals

The Headache Navigator is based on the Primary Care Management of Headache in Adults clinical practice guideline and quick reference algorithm produced by Towards Optimized Practice (TOP). It assists primary care providers in managing primary headache disorders.

To access the tool, please visit:

Low back pain: CORE Back tool update

We received great feedback from primary care providers that the CORE Back Tool was having an important impact on the assessment and management of patients with Low Back Pain in their practices. We learned that the CORE Back Tool has been integrated into EMRs, provider education and patient engagement strategies. Over 5000 providers participated in CEP’s online education course, ‘Primary Care focus on Low Back Pain’. What did providers ask for again and again? More information on linking assessment to patient education and more management options!

CEP has responded to this request and updated the CORE Back Tool and is in the process of updating the online education course. Thank you to all of the providers who gave feedback, to our Clinical Working Group, Focus Group, one-on-one user design participants, and to our Clinical Lead Dr. Julia Alleyne and Experts Drs. Hamilton Hall and Raj Rampersaud for their hard work and support.

To access the CORE Back Tool, 2016 visit:

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