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GP, Consultant & PCT Referal Guidelines

Musculoskeletal Pathway for Early Management Back Pain in Primary Care

General Medical Council guidance allows referral by GPs to chiropractors as statutorily regulated health professionals.8

The British Medical Association has also published referral guidance for GPs.9

30% of all GP consultations are about musculoskeletal complaints.1

10% of back pain patients take up 90% of its healthcare costs.2

For most patients with back pain, evidence suggests that it resolves in three to four weeks after onset if an evidence-based approach is used.

For patients in whom the pain persists beyond six weeks, the National Institute for Health and Clinical Excellence's (NICE) guidance is to provide advice and promote self management.3 Three treatment options are also recommended: an exercise programme, a course of manual therapy or a course of acupuncture, considering patient preference.

The Department of Health has also issued its recommendations for the treatment of back pain in the Musculoskeletal Services Framework.1 This framework suggests GP referral of patients to Musculoskeletal Clinics to avoid counterproductive NHS waiting lists which include: Chiropractors, Osteopaths, GPs with a special interest (GPwSI), specialist consultants, nurses, allied health professionals or clinical psychologists.

So Why Chiropractic?

Chiropractic has been consistantly shown to be more effective than the treatments to which it has been compared.4,5,6 Chiropractic intervention, including manipulation, is safe,6 (see our 'risks' page) effective and cost effective in reducing referral to secondary care.6

Chiropractic is concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, the effects of these disorders on the nervous system and on general health. There is an emphasis on manual treatment, including soft tissue work, spinal manipulation (adjustments), as well as advice and rehabilitation exercise programmes. For this reason, Chiropractic fits perfectly into the current evidence based clinical guidelines, which recommend a biopsychosocial approach to treatment, to include:

  • physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercise.
  • guidance on activity, lifestyle, prognosis and prevention.
  • advice about pain control, including nonprescription medication.
  • psychosocial interventions aimed at resolving cognitive barriers to recovery.

Chiropractors are fully regulated by the General Chiropractic Council. They are required to have completed a 4 or 5 year honours degree or undergraduate masters, BSC(hons) MSc(Chiro) and a post graduate 'in practice' training to gain their DC qualification. Pre-registration training includes differential diagnosis/triage, radiology/radiography, qualifying them as primary healthcare practitioners.

Chiropractors mainly treat:

  • back and postural problems
  • joint (arthritis) and muscle problems
  • leg pain and sciatica
  • neck, shoulder and headache problems
  • sports injuries.

The main aims of treatment are:

  • alleviation of distress and control of pain
  • restoration of normal functioning and activity

.......and Why Us?

At The Chiropractic Clinic, we are firmly commited to this evidence based approach to practice. We don't sell general 'wellness', or indeed claim to be able to treat any problems outside our field of Chiropractic, evidence supported expertise. Primarily we are 'pain' or more accuratley 'symptom' based practitioners. 'Symptoms' are what motivates patients to seek our help, and therefore rapid symptomatic relief is our immediate focus. We acheive this by ensuring that the underlying causes of those symptoms are identified, expained and resolved, and we educate the patient to equip them with the knowledge and the tools that they need to avoid any future reocurance.