Abstract
Introduction and aims
Low back pain is a common complaint, affecting up to one third of the adult population costing over £1 billion to the NHS each year and £3.5 billion to the UK economy in lost production. The demand for spinal injections is increasing allowing for advanced spinal physiotherapists to perform the procedure. The objective of this study was to investigate outcome following spinal injections performed by consultant spinal surgeon (n=40) and advanced spinal physiotherapists (ASP) (n=40) at our centre.
Method and Materials
Data on 80 patients who had received caudal epidural (n=36), nerve root block (n=28) and facet joint injections (n=16) form August 2010 to October 2011 consented to be in the study. 40 patients in each group completed Oswestry Disability Index (ODI), Visual Analogue Scores (VAS) before and 6 weeks after the procedure and patient satisfaction questionnaire investigating their experience and any complications related to the spinal injection retrospectively. The study included 32 males and 48 females. Mean age 57 years, range 21–88. [Consultant group M:17, F:23 mean age: 55, range 21–81. ASP group M:15, F:25 mean age 59, range 22–88]. Measures of patient satisfaction and outcome were obtained; using 2 tailed independent samples t-test with 95% confidence interval, statistical significance was investigated.
Results
Data analysis shows that there are no significant differences (p>0.05) in either overall patient satisfaction or outcomes between patients of the surgeon vs physiotherapists. Patients of the surgeon were found to be more satisfied with the procedure itself (p< 0.05).
Conclusion
Physiotherapists are able to provide spinal injections with equal efficacy to spinal surgeons, with no reduction in overall patient outcome. Benefits of this scheme include greater number of spinal injections performed. Therefore, reducing the overall waiting times. Further, multi-centre studies on larger populations are required to investigate injection treatment by physiotherapists.
