Abstract
With an alarming 10% increase in disability payments for backpain annually, the importance of early management of backpain within the first 6 weeks is paramount. The problems of a long and often agonising waiting time for a hospital consultation has been overcome by setting up of the Alexandra Hospital Backpain Assessment Clinic (ABPAC) with initial and immediate consultation by a trained clinical physiotherapist.
From the period March 1995 to March 1999 a total of 1881 patients werw reviewed by the ABPAC and an analysis of these cases is presented. 640/1881 (34%) patients were assessed, advised and discharged. 535/1881 (28%) patients were assessed, given supervised physiotherapy, advised and discharged. 169/1881 (16%) patients were assessed, investigated and discharged. In all 292/1881 (16%) patients needed actual review by consultant, out of which only 48 (2.5%) needed surgery. Only 63/1881 patients needed an MRI scan. There were only 2 patients who were found to have serious pathology in the form of spinal metastasis and only 5 were inappropriate because non-spinal pathology was picked up at initial assessment. There were no “missed” diagnosis.
Thus the clinic with its emphasis on examination and advice rather than “treatment” does not allow for repeated series of consultations nor the development of “regulars” who become dependent on the hospital for treatment, saving the NHS serious money and consultant time. This study proves that such a clinic apart from being safe, is also well accepted by patients and referring G.Ps alike. An outline of its working and the management algorithms is presented.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin
