Outpatient Clinics

The Backpain Assessment Clinic is the initial entry point for all adult patients with non-emergency back pain into the THS. The clinic provides triage for patients referred for specialist management of non-emergency low back pain and/or radicular leg symptoms lasting longer than 6 weeks who have failed to respond to conservative therapy.Patients are assessed by a multi-disciplinary team and includes screening to determine need for surgical intervention and/or exclude serious pathology. A management plan will be formulated with the patient and communicated to the GP and patient. Further investigations and onwards referral will be arranged as indicated.

Availability

North South North West Statewide

Scope

The aims of the clinic are to:

• assess for the presence of serious pathology as a cause of symptoms
• determine a need for surgical intervention and refer to Neurosurgery as required
• determine whether further investigations (with a view to an injection or surgical procedure) are required
• plan immediate and long-term management, including appropriate self-management strategies
• make onward referrals to other health providers as indicated (e.g. Persistent Pain Service or Community Physiotherapy

Exclusions:

Patients who are currently receiving management from other services for the same problem, including the Persistent Pain Service or Department of Neurosurgery, will not be offered appointments. BAC will accept patients transferring from the Neurosurgery waiting list.

Paediatric patients with LBP are not seen in BAC and should be referred to other services.

BAC is not currently resourced to see persistent neck/thoracic pain, acute spinal pain or patients residing in the North and North-West of Tasmania. These patients will be triaged and referred to the appropriate service.

Emergency conditions

Clear documentation of Red Flags (particularly objective findings) will assist with triaging and prioritisation of patients.

Patients presenting with:

*cord compression (hyperreflexia / gait abnormalities)

*cauda equina signs / symptoms (bladder/bowel dysfunction, saddle paraesthesia)

*severe or rapidly progressing neurological deficits, including acute foot drop

*spinal disorder with red flags indicating tumour or infection

*significant spinal trauma

should be referred urgently to Neurosurgery via the Emergency Department. Please call the Neurosurgery Registrar on-call to advise of the presenting patient and relevant history.

Referral process

Please include relevant clinical history, any private investigation results and information on current neurological signs

Ask patients to bring current medication list and, if appropriate, any relevant imaging/ investigations.

NB: Additional imaging is not indicated unless there are neurological signs / other red flags or a history of trauma.

Prior to the first appointment patients will be sent four questionnaires (linked below) to return to the clinic. Whilst not essential, referrers may wish to expedite this step by providing the questionnaires to their patient and assisting with the completion of them where necessary.

MTAS – Backpain Assessment Clinic Patient Questionnaire

Pain Self-efficacy Questionnaire

Orebro Musculoskeletal Pain Questionnaire - Short

Oswestry Low Back Pain Disability Questionnaire

The questionnaires may be faxed with the referral or posted separately to the Physiotherapy Department Royal Hobart Hospital, GPO Box 1061, Hobart TAS 7001.

Clinic Appointments - Appointments are based on clinical priority, according to the referral information provided.

Referral template

For use by health professionals only

• Referral template - Medical Director
• Referral template - Best Practice

Additional information

Back Assessment Clinic Patient Information Brochure