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New clinic offers rapid access to customized care for patients with low back pain

Kirstin Henderson (left), practice lead for the ISAEC program

Kirstin Henderson (left), practice lead for the ISAEC program, explains parts of the spine to a patient. Education is one of the focuses of the ISAEC.

Lynne Miles is grateful that her life has returned to normal. She felt debilitating low back pain for three months before she went to the Inter-professional Spine Assessment and Education Clinic (ISAEC) at The Ottawa Hospital.

Lynne’s severe low back pain started suddenly in October 2018 and ran down her left leg. She lost sensation in her left foot. She couldn’t bend down or sit. The pain was so intense that she refused to sit during a job interview. Driving was impossible. Even though she has a high pain tolerance, the low back pain was affecting her psychologically.

To help her cope, her family doctor prescribed painkillers, but there was no improvement. In an effort to get better, Lynne tried alternative manual therapies such as chiropractor manipulation, acupuncture, physiotherapy and massage. Nothing made her condition manageable. Having run out of ideas, Lynne returned to her family doctor.

That’s when she was referred to ISAEC at The Ottawa Hospital.

“I left from my first appointment at the ISAEC with an exercise plan, a referral to physiotherapy and a new prescription,” explained Lynne. Two-and-a-half weeks after her initial visit to ISAEC, Lynne’s pain went from a nine to a two on the ten-point pain scale.

“It was like night and day,” she said.
 Models of the spine
Models of the spine give patients a real-life understanding of low back pain and how to manage it.

The ISAEC program is a provincial initiative that aims to reduce the long waiting time to see a specialist. It aims to provide patients with rapid access to specialized, holistic care they need with a focus on education and self-management. The evaluation for the pilot program showed a 99 percent patient satisfaction rate.

“Patients who are referred to ISAEC receive standardized rapid assessments where their condition is looked at more holistically and they are given personalized self-management plans,” explained Kirstin Henderson, practice lead for the ISAEC program.

The ISAEC helps direct patients to the most appropriate care if required. The focus is to identify and direct a plan of care for each patient based on their specific issues using evidence-based recommendations. Patients are empowered to undertake their plan with guidance over time.

“The ISAEC model allows us to help patients manage low back and low-back pain-related symptoms before they become chronic,” added Henderson. “The program empowers the patients, giving them the tools to help themselves and to manage their condition.”

Patients referred to the ISAEC receive standardized rapid assessments
Patients referred to the ISAEC receive standardized rapid assessments and customized self-management plans to help them manage their low back pain.

Back pain is one of the most common reasons to visit a doctor, chiropractor or physiotherapist (Power et al 2006). Four out of five adults will experience at least one episode of back pain at some time in their lives, according to Statisticss Canada. Triaging these patients properly is very important. Incorrect assessment delays treatment and unnecessarily prolongs the wait times for patients who need surgery.

Since ISAEC was fully implemented in February 2019, 600 patients have been seen and less than five percent of them have needed MRI or surgery.

More facts about the ISAEC:

  • Patients must have symptoms lasting less than one year to be eligible for the ISAEC.
  • A referral from a family doctor who completed a short online training course is required.
  • Patients referred to the ISAEC program are seen within four weeks.
  • There is no hands-on treatment provided at the ISAEC clinics. Practitioners in the community with specialist training perform that role.
  • Patients who go to the ISAEC clinic who require referrals for imaging, epidural injections or surgical consultation will see that process go faster than normal.

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