Effects of musculoskeletal expert input on low back pain outcomes: A randomised controlled trial
Abstract
Background: Overuse of low-value interventions and delays in accessing appropriate care contribute to the growing burden of low back pain (LBP). Integrating musculoskeletal health experts into care pathways may represent a pragmatic strategy to improve access, referral appropriateness, and efficiency of spine care delivery.
Purpose: This study evaluated the effects of an evidence-based triage assessment performed by chiropractors on clinical outcomes and care trajectories of patients with LBP referred for a neurosurgical consultation. We hypothesised that the intervention would produce equivalent clinical outcomes while improving care trajectories.
Study design: Single-center, parallel-group randomised controlled trial.
Outcome measures: Patient reported measures were collected at 1 week, 3, 6 and 12 months, including back pain intensity (primary outcome), leg pain intensity, LBP-related disability, quality-of-life, perception of change, and care trajectories.
Methods: One hundred and one adults with LBP were randomized to the intervention (n = 52) or control group (n = 49). All participants underwent a standardized chiropractor-led triage evaluation prior to the neurosurgical consultation. In the intervention group, the chiropractor's assessment findings and recommendations were communicated to the neurosurgeon before the consultation, whereas they were not shared for the control group. Equivalence for the primary outcome (back pain intensity) was assessed at the 3-month…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 52 participants or records.
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