Spinal Assessment

Initial secondary care assessment of patients with persistent low back pain and/or radicular leg symptoms lasting longer than six weeks who have failed to respond to conservative therapy in the community. Patients are assessed by a physiotherapist or pain registrar in association with Rheumatologist. A management plan will be formulated with the patient and communicated to the GP. Referral to Persistent Pain Unit or neurosurgery with appropriate work up will be undertaken where indicated.

Availability

North South North West Statewide

Scope

THS Southern Region Only

The aims of the assessment are to:

  • identify the mechanical and psychosocial factors associated with the patient's symptoms
  • determine whether further investigation is required
  • plan immediate and long-term management, including appropriate self-management strategies
  • make onward referrals (e.g. to the Persistent Pain Service or Dept. of Neurosurgery) where indicated

NB. The Spinal Assessment Clinic places emphasis on self-management strategies and recommendations for implementation in Primary care. It is not an ongoing treatment clinic.

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. However, SAC will accept patients transferring from the neurosurgical clinic waiting list.

SAC is not currently resourced to assess persistent neck/thoracic pain, or acute spinal pain.

Emergency conditions

Emergency conditions/symptoms include (not an exhaustive list):

  • Patients with cauda equina symptoms or acute foot drop should be referred urgently to neurosurgery or via ED.

Referral process

A referral (preferably faxed) is required for all new appointments and must conform to the Referral Standards as outlined on For Clinicians.

Specific requirements are detailed in the individual clinic and condition referral guidelines.

Please provide copies of all imaging reports and any other relevant investigations

All referrals are triaged according to clinical information provided in the referral. Any of the Spinal Assessment clinicians may undertake the initial assessment.

Clinic Appointments - Appointments are based on clinical priority:

Emergency

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED
– Phone: (03) 6777 6405 Fax: (03) 6348 7382
MCH ED
– Phone: (03) 6478 5120 Fax: (03) 6426 5115
NWRH ED
– Phone: (03) 6493 6000 Fax: (03) 6430 6691
RHH ED
– Phone: (03) 6166 6100 Fax: (03) 6222 8919

Urgent / category 1

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent / category 2

We will endeavour to see these patients within 12 weeks

Routine / category 3

Next available appointment

Referral template

For use by health professionals only

Additional information

For more acute/episodic pain consider referral to Acute Low Back Pain Drop In Clinics.