Doctor-chiropractor team can ease low back pain, project finds
Doctors reported sending fewer patients for tests and surgical specialists after an assessment and recommendations by a chiropractor during the Ministry of Health-funded study by the Ontario Chiropractic Association.
Cutting the long wait for tests and specialist referrals is a huge relief for patients, said Jan Kasperski, chief executive officer of the Ontario College of Family Physicians.
“That period of waiting for a definitive diagnosis and wondering if they’re going to end up with surgery is really difficult for them,” Kasperski said.
And, she added, “I think these people end up having chronic problems because of the wait.”
The traditional route is referring patients to an orthopedic surgeon and ordering MRIs to determine if surgery is necessary, a long process and in most cases surgery is not warranted. Meanwhile, a patient can often become inactive out of fear of further aggravating the condition and simply because of the discomfort.
“It’s wildly frustrating for patients to be sent off and go through that loop,” said Robert Haig, chief executive officer of the Ontario Chiropractic Association.
Back pain that is not well managed leads to lost work time and long-term disability, costing the economy and health care system.
“There seems to be a gap in the treatment of back pain in Ontario. It’s a very significant health problem,” Haig said.
The pilot project involved chiropractors working in a doctor’s office, doing a 30-minute assessment of a patient’s low back pain and offering education, then discussing treatment options with the doctor. Recommendations could include exercises that can be taught quickly right in the office, chiropractic treatment and physical, occupational or massage therapy.
Satisfaction was high among family doctors, who find it challenging to treat recurring back pain on their own, as well as patients, who noted increased confidence in diagnosis and treatment by getting the combined expertise.
“They were reassured about their problem,” Haig said. Back pain “can be an extremely debilitating thing and scary.”
Collaboration is appreciated by chiropractor Jennifer Nash, who works at the health services centre on Wilfrid Laurier University’s Brantford campus. She treats patients alongside the other health care professionals, even using the same electronic records, and she can simply ask a doctor when she has a question about a patient’s care.
“There’s so much value,” Nash said.
Historically, she said, low back pain was treated with bed rest and pain medication, while now treatment includes exercise, education and manual therapies and that shift has given rise to an interdisciplinary approach.
Nash, along with the doctor and chiropractor associations, want to see more multidisciplinary teams, especially with this new evidence the model provides good care and use of resources. Also, new doctors expect to work with other health care professionals, Kasperski said.
“Hopefully it will take off across the province. It certainly deserves to.”