The Physiotherapist as an Orthopaedic Assistant in a Back Pain Clinic

The spinal unit at Exeter receives about 80 new referrals for back pain every month. To reduce waiting times and costs, a specially trained physiotherapist reviewed patients with back or leg symptoms referred by general practitioners. This paper reviews the outcome at 18 months of 285 referrals assessed in this way. Twenty-seven patients failed to attend. The remaining 258 were assessed by the physiotherapist and six who did not have a spinal problem were referred to other departments. The remaining 252 form the basis of this review. The physiotherapist alone saw and managed 70% of the patients and at 18 months 41 % of the total had been discharged. Only 30% of those originally presenting with a back pain problem needed to see the surgeon and only 14% came to surgery. Using the system described and with a good working relationship with the surgeon, a chartered physiotherapist can successfully screen and treat patients in a low back pain clinic. In this way, the same level of care is maintained and the surgeon is deployed in a more productive manner. Patients benefit because they are seen more quickly and, where appropriate, investigations are started sooner. If they need physiotherapy, this can be arranged at the time of their hospital appointment.