Rapid-access clinic for lower back pain available in Cornwall

Last October, Lynne Miles was hit with excruciating back pain – to the point she couldn’t even sit down. After months of searching for help she was finally referred to the Interprofessional Spine Assessment and Education Centre (ISAEC) at the Civic Hospital. Within two weeks, she says, the sciatica which had crippled her was managed and she could function again. A new spinal care option developed by The Ottawa Hospital has been rolled out across the Champlain Local Health Integration Network and is now available in Cornwall to those experiencing lower back pain.

The Interprofessional Spine Assessment & Education Clinics (ISAEC) program has been run as a pilot project in Toronto, Hamilton and Thunder Bay for the past five years, and because of its success in those communities is now being introduced across the province. But the Champlain LHIN is first to get it so far.

The idea behind the ISAEC clinics is to give people a faster way to find treatment for lower back pain without surgery. Patients with severe back pain are often referred to surgeons for assessments of their conditions, but the new clinics will offer alternatives for patients with fairly new symptoms that will see them within three weeks and may provide ways to them from having to go under the knife altogether such as exercise plans or other non-invasive treatment recommendations.

“Patients who are referred to the program receive rapid assessments and are given personalized self-management plans,” explained Kirstin Henderson, practice lead for the ISAEC program. “We’re trying to get to people before their symptoms become chronic, to help patients access treatment in a more timely fashion and reduce the burden on the health care system itself.”

The clinics use “extended scope healthcare professional” to run the clinics, meaning they are being based out of existing chiropractic and physiotherapist practices.

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“They already have a knowledge of lower back pain, but we’ve given them additional training to enable them to do this kind of triage role,” said Henderson. “There is not hands-on treatment at the clinics … patients get a standardized focused assessment where their condition is looked at more holistically.”

Cornwall’s clinic is already set up and seeing patients at a local physiotherapy practice, but accessing ISAEC program requires a referral from a family doctor, and is also limited to people whose symptoms have not yet become chronic; meaning they have been experiencing them for less than a year.

Patients who go to the ISAEC clinics and still need an imaging referral or a surgical consultation will see that process expedited. Henderson said it’s a win-win.

“That way patients who need specialist care get it more quickly and those who don’t actually get the input they were lacking before,” she said.

The idea worked for Ottawa patient Lynne Miles, who was suffering from severe pain before attending one of the clinics in Ottawa.

“It ran down my left leg. I had no sensation in my left foot. I couldn’t bend over. I couldn’t sit. The pain was affecting me psychologically,” she said.

“I truly was at the end of my ability to cope. I felt I could not go on in that situation.”.

Miles had been prescribed painkillers that were “barely working” before her initial visit to the clinic. But after an assessment by a nurse-practitioner in consultation with a surgeon, she was prescribed higher doses of a drug to reduce nerve inflammation and irritation. That allowed her to reduce pain medication and to be more successful with physiotherapy.

There will be another visit in a few weeks, in which she might be given epidural injections in the spine and then her condition will be further assessed.

Miles’s issues have not disappeared, but they are now manageable.

“I can’t even put it into words. I am back to my normal mental and emotional state. I still can’t bend over, but I can sit. It is day and night compared to what it was like.”

-With files from Elizabeth Payne, Ottawa Citizen
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