TranslateNon-Emergency Low Back Pain
Outpatients | Back Assessment Clinic (non-emergency low back pain)
This condition is treated in the Back Assessment (non-emergency low back pain) clinic.
Pre-referral work-up
History
Emergency lower back pain conditions should be referred directly to the Emergency Department for immediate assessment and care. In the North and North-West, please contact the Emergency Department Medical Officer in Charge. In the South, please call the Neurosurgery Registrar on call to advise of the presenting patient and relevant history.
See list of Emergency low back pain conditions below.
Non-emergency lower back pain conditions should have exhausted non-operative management options (including physiotherapy) before referring for specialist assessment.
In the South, patients with non-emergency lower back pain with or without lower limb neurological signs and symptoms requiring specialist assessment and management, including surgical opinion, should be referred to the Back Assessment Clinic.
In the North and North-West, patients with non-emergency lower back pain, with or without neurological signs and symptoms, requiring specialist assessment and management, including surgical opinion, should be referred to the State-wide Neurosurgery Service.
All referrals should comply with the referral standards and specifically include:
- Duration of symptoms
- Presence of neurological symptoms and signs
- Functional impairment including time off work
- Systemic symptoms
- Treatment to date including previous spinal surgery or malignant disease
- Height, weight and BMI
Tests
Investigations, if there is suspicion of red flags or symptoms persist despite an adequate trial of conservative management:
- Plain X-rays and CT or MRI (MRI preferable if available)
- FBC/CRP/ESR
- LFT, U&E, CR
Consider calcium and phosphate, electrophoresis, immunoglobulins, PSA, rheumatoid serology in specific cases.
Interim/GP management
To refer a patient with this condition, please see the Back Assessment Clinic (Non-Emergency Low Back Pain) clinic page for the full referral process and templates.
Consider referral to Community Physiotherapy before referral to Back Assessment Clinic.
Simple analgesia including paracetamol and NSAIDs should be trialled.
Advice re weight loss and suitable exercise to maintain mobility should be offered.
For more information please see the HealthPathways Tasmania website.
Clinic appointments
🚩 Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
Emergency
Red Flags
🚩 Acute Cauda Equina Syndrome (back pain with bladder/bowel dysfunction/saddle paraesthesia)
🚩 Severe / rapidly progressing neurological deficits including acute foot drop
🚩 Cord signs or symptoms including gait abnormalities and/or hyperreflexia
🚩 Infective spinal disorder
🚩 Spinal fracture with evolving neurological deficit
🚩 Unstable spinal fracture
If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.
Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.
Urgent (Category 1)
- Risk of irreversible deficit if not seen within 1-4 weeks
- Spinal tumours (benign or malignant)
- Stable spinal fractures without evolving neurological deficit
We will endeavour to see these patients within 4 weeks
Semi-urgent (Category 2)
We will endeavour to see these patients within 90 days, or sooner if clinically indicated.
Routine (Category 3)
Next available appointment. We will endeavour to see these patients within 365 days.
Availability
North
Southern based clinic
North West
Southern based clinic
South
Phone: 6166 0162
Fax: 6234 9941
Patients may be seen in the Wellington Clinics or at a Community Health Centre location depending upon clinical presentation, patient preference and clinic capacity.
