EMERGENCY DEPARTMENT REFERRAL TO A HOSPITAL-BASED CHIROPRACTIC CLINIC FOR A PATIENT WITH CHRONIC LOW BACK PAIN

Main Article Content

M. Connor Jordan
Nate Hinkeldey

Keywords

Emergency Department, Interdisciplinary Care

Abstract

Objective:  To demonstrate coordination of care between an emergency department and a hospital-based chiropractic clinic for a patient with chronic low back pain. 


Clinical Features:  35-year-old female patient with chronic low back pain since 1999. She had received care from the emergency department, primary care, physical therapy, and a number of other providers before being referred to the chiropractor in 2017.


Intervention and Outcome: Physiotherapist evaluate and manage musculoskeletal conditions in patients seen in the emergency department, with no adverse outcomes. Chiropractors receive similar training as physiotherapist in diagnosis and management of musculoskeletal conditions and could also fill a similar role within the emergency department. 


Conclusion: Chiropractors can, similar to physiotherapists, evaluate and manage patients with musculoskeletal conditions seen in an emergency department setting

Downloads

Download data is not yet available.
Abstract 99 | EMERGENCY DEPT. REFERRAL Downloads 79

References

1. Prevalence of Select Medical Conditions (Internet). BMUS: The Burden of Musculoskeletal Diseases in the United States. (cited 2020May25). Available from: https://www.boneandjointburden.org/fourth-edition/ib0/prevalence-select-medical-conditions
2. Edwards J, Hayden J, Asbridge M, Gregoire B, Magee K. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskeletal Disorders 2017Apr;18(1)
3. Edwards J, Hayden J, Asbridge M, Magee K. The prevalence of low back pain in the emergency department: a descriptive study set in the Charles V. Keating Emergency and Trauma Centre, Halifax, Nova Scotia, Canada. BMC Musculoskeletal Disorders 2018;19(1)
4. NACRS emergency Department visits and length of Stay, 2017–2018. (n.d.). Retrieved March 02, 2021, from https://www.cihi.ca/en/nacrs-emergency-department-visits-and-length-of-stay-2017-2018
5. Galliker G, Scherer DE, Trippolini MA, Rasmussen-Barr E, Lomartire R, Wertli MM. Low Back Pain in the emergency department: prevalence of serious spinal pathologies and diagnostic accuracy of red flags. Am J Med 2020;133(1)
6. Sutton M, Govier A, Prince S, Morphett M. Primary-contact physiotherapists manage a minor trauma caseload in the emergency department without misdiagnoses or adverse events: an observational study. J Physiotherapy 2015;61(2):77–80
7. Taylor NF, Norman E, Roddy L, Tang C, Pagram A, Hearn K. Primary contact physiotherapy in emergency departments can reduce length of stay for patients with peripheral musculoskeletal injuries compared with secondary contact physiotherapy: a prospective non-randomised controlled trial. Physiotherapy 2011;97(2):107–114
8. Bird S, Thompson C, Williams KE. Primary contact physiotherapy services reduce waiting and treatment times for patients presenting with musculoskeletal conditions in Australian emergency departments: an observational study. J Physiotherapy 2016;62(4):209–214
9. Paskowski I, Schneider M, Stevans J, Ventura JM, Justice BD. A hospital-based standardized spine care pathway: report of a multidisciplinary, evidence-based process. J Manipulative Physiol Ther 2011;34(2):98-106 doi:10.1016/j.jmpt.2010.12.004
10. Kosloff TM, Elton D, Shulman SA, Clarke JL, Skoufalos A, Solis A. Conservative spine care: opportunities to improve the quality and value of care. Population Health Management 2013;16(6), 390–396. https://doi.org/10.1089/pop.2012.0096
11. Schielke AL, Babikian AR, Walsh RW, Rajagopal P. Implementation of musculoskeletal specialists in the emergency department at a level A1 VA Hospital during the SARS-CoV-2 pandemic. AM J Emergency Med 2020; S0735-6757(20)30894-9. Advance online publication. https://doi.org/10.1016/j.ajem.2020.10.010
12. Pugh A, Roper K, Magel J, et al. Dedicated emergency department physical therapy is associated with reduced imaging, opioid administration, and length of stay: A prospective observational study. PLOS ONE 2020;15(4):e0231476 https://doi.org/10.1371/journal.pone.0231476
13. Fritz JM, Childs JD, Wainner RS, Flynn TW. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. Spine 2012;37(25):2114-2121. doi: 10.1097/BRS.0b013e31825d32f5. PMID: 22614792
14. Frogner BK, Harwood K, Andrilla C, Schwartz M, Pines JM. Physical therapy as the first point of care to treat low back pain: an instrumental variables approach to estimate impact on opioid prescription, health care utilization, and costs. Health Services Res 2018;53(6), 4629–4646. https://doi.org/10.1111/1475-6773.12984
15. Childs JD, Fritz JM, Wu SS, et al. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Services Res 2015;15:150. https://doi.org/10.1186/s12913-015-0830-3
16. Marshall PWM, Schabrun S, Knox MF. Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain. PLOS One 2017Jul;12(7)
17. Beliveau PJH, Wong JJ, Sutton DA, et al. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Ther 2017;25(1)
18. Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil 2011;92(12):2041-2056. doi: 10.1016/j.apmr.2011.07.198. PMID: 22133255
19. Carragee EJ, Hannibal M. Diagnostic evaluation of low back pain. Orthop Clin North Am 2004;35(1):7-16. doi:10.1016/S0030-5898(03)00099-3
20. Deyo RA, Weinstein JN. Low back pain. New Engl J Med 2001;344(5):363–370. https://doi.org/10.1056/NEJM200102013440508
21. Carey TS, Garrett JM, Jackman A, Hadler N. Recurrence and care seeking after acute back pain: results of a long-term follow-up study. North Carolina Back Pain Project. Med Care 1999;37(2):157–164. https://doi.org/10.1097/00005650-199902000-00006