By Dr. Aly Abdulla,
BSC, MD, LMCC, CCFPC, DipSportMed CASEM, FCFCP, CTH (ISTM), CCPE, Masters Cert Phys Leader
Medical Director The Kingsway Health Centre
FHO Lead Manotick Rideau River South BAPH
Assistant Professor The University of Ottawa Faculty of Medicine
Clinical Instructor The University of Ottawa Faculty of Nursing
Ottawa West LHIN Subregional Clinical Lead
I am a family doctor in Manotick in a 20 doctor Family Health Organization (FHO). I am also a sports medicine doctor so I receive many referrals for various musculoskeletal issues. The most common referral is for chronic low back pain (LBP). These patients don’t seem to get better with conventional therapy or after so many weeks. There is a consideration for an MRI and a neurosurgeon consult but the wait list is too long so they decide to send the patient to me. Many doctors (and patients) find this challenging.
But there is another option:
The ISAECS Interprofessional Spine Assessment and Education Program is a great resource in our community to manage these cases. In addition, they provide a robust educational program online (for patients and doctors) at your convenience to improve outcomes. Here are some highlights:
- Is your pain back or leg dominant?
- Is the pain constant or intermittent?
- What position makes it worse/better (flexion or extension)?
- What have you tried and failed?
- How disabled are you?
- The use of red flags (NIFTI guide for critical pathology),
- yellow flags or STarT Back (for risk of chronicity) and
- the Opioid Risk Tool (to prevent addiction).
The biggest benefit is the patient self-management and the CORE back tool home exercises.
The ISAEC program provides optimisation of conservative management including exercise prescription, education and advice, support and appropriate referral if needed.