Table 3

Classification of recommendations

	OA				LBP				Neck pain		Rotator cuff
	AAOS	EULAR	OARSI	NICE	Globe et al	NICE	Danish	Belgium	Bussieres et al	OPTIMa	NSW
Management principles
Patient-centred care	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓
Assessment
Diagnosis: exclude serious pathology				✓✓	✓✓	✓✓		✓✓	✓✓	✓✓	✓✓
Diagnosis: classify neck pain grades I–IV									✓✓	✓✓
Assess psychosocial factors		✓✓		✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓
Routine use of radiological imaging				O	O	O	O	O			O
Undertake physical examination		✓✓		✓✓	✓✓	✓✓		✓✓		✓✓	✓✓
Evaluation/re-evaluation and measurement		✓✓		✓✓	✓✓					✓✓	✓✓
Management
Provide education/information		✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓	✓✓
Prescribe physical activity/exercise	✓✓	✓✓	✓✓	✓✓	✓	✓✓	✓	✓✓	✓✓	✓✓	✓✓
Offer self-management programmes	✓✓		✓✓	✓✓	✓				✓	✓
Weight loss if overweight/obese	✓	✓✓	✓✓	✓✓
Pharmacological: paracetamol alone	?		✓✓	✓		O	O	O	✓	O	✓✓
NSAIDS	✓✓		✓	✓		✓	O	✓	✓	✓	✓
NSAIDS plus paracetamol				✓							✓
Opioids – acute pain	✓		?	✓		✓	O	✓	?		?
Opioid – chronic pain	✓		?	✓		O		O	?
Muscle relaxants								O	✓	✓
Glucosamine and chondroitin	O		O	O
Capsaicin			✓✓	✓
Selective serotonin reuptake inhibitors						O		O
Serotonin– norepinephrine reuptake inhibitors, tricyclic antidepressants or anticonvulsants						O		O
Passive interventions – non-invasive: manual therapy	?			✓	✓✓	✓	✓	✓	✓	✓	✓
If used, use manual therapy with other modalities				✓✓	✓✓	✓✓	✓✓	✓✓			✓✓
Electrotherapy			O	✓	✓	O		O	✓	✓	O
Braces/orthoses	?	✓	✓	✓	✓	O		O	?	O
Psychological therapy					✓	✓	✓	✓	✓	O
Passive interventions – invasive: surgery. Trial conservative care first before surgery.				✓✓		✓✓		✓✓			✓✓
Knee arthroscopic lavage and debridement for OA	O			O
Disc replacement for LBP						O		O
Passive interventions – invasive: injections Intra-articular corticosteroid injection for knee OA	?		✓	✓
Injections for LBP						O		O
Epidural injection for acute and severe radicular pain						✓	O	✓
Complementary medicine: acupuncture	O		?	O	✓	O	O	?			✓
Facilitate continuation/resumption of work		✓✓				✓✓	✓	✓✓		✓✓	✓✓

✓✓Should do; ✓ Could do; O Do not do; ?Uncertain.
AAOS, American Academy of Orthopedic Surgeons; EULAR, European League Against Rheumatism; LBP, low back pain; NICE, National Institute for Health and Care Excellence; NSAIDS, non-steroidal anti-inflammatory drugs; OA, osteoarthritis; OARSI, Osteoarthritis Research Society International; OPTIMa, Ontario Protocol for Traffic Injury Management Collaboration.