Low Back Pain Rapid Access Clinic (RAC) Information for Patients and Families
What to Expect and Frequently Asked Questions
Who is eligible for this program?
The program is for patients who are over 18 years of age living with:
- Persistent low back pain and/or related symptoms (e.g., sciatica, neurogenic claudication) 6 weeks to 12 months post-onset; or,
- Unmanageable recurrent/episodic low back pain and/or related symptoms of less than 12 months post-recurrence.
This program is not intended for patients with:
- Initial low back related symptoms <6 weeks post onset;
- Constant/persistent LBP-related symptoms >12 months post onset <18 years of age;
- Unmanaged established chronic multisite pain disorder;
- Unmanaged established narcotic dependency;
- Active LBP-related WSIB claim;
- Active LBP-related motor vehicle accident claim;
- Active LBP-related legal claim;
- Pregnant/post-partum patients (<1 year); and
- Patient with RED FLAGS. Patients with the following emergent red flags should be referred directly to the closest Emergency Department:
― Possible Cauda Equina Syndrome (saddle anesthesia about anus, perineum or genitals; urinary retention with overflow incontinence; loss of anal sphincter tone/fecal incontinence);
― Progressive neurologic deficit; and
― Significant trauma.
How can I be referred to a RAC?
Ask your primary care provider (PCP) to send a referral to Central Intake, where the referral will be sent to a RAC closest to your home. The RAC will contact you directly to schedule an appointment within four weeks of referral. Note: the referring PCP must be registered through the ISAEC website: http://www.isaec.org/isaec-registration.html.
What is an Advanced Practice Provider (APP)?
An APP is a physiotherapist who has received specialized training with orthopaedic surgeons in low back care. APPs are located at a community-based RAC and will conduct your assessment(s).
What do I need to do before my appointment?
To optimize your time with your APP, please download and complete the Patient Intake Form prior to your first appointment, available here: www.isaec.org. Alternatively, you may arrive 15 minutes early to your appointment and the Patient Intake Form can be completed at the RAC waiting room.
What happens during an assessment with an APP?
- The APP will perform a physical examination and discuss the history of your condition.
- You will be provided with a self-management plan to better manage your pain, improve your mobility, as well as your overall function. Certain patients may be advised to seek additional services (e.g., exercise rehabilitation, manual therapy) that may not be provided by this program.
- You may be asked to return to the APP a follow-up assessment (up to four), if appropriate.
- Patients who are potential surgical candidates will be referred onto the Practice Lead at Scarborough Health Network.
What is a Practice Lead?
A Practice Lead is a hospital-based health care professional who works closely with local orthopaedic surgeons to manage potential surgical candidates. The Practice Lead, located at the Scarborough Health Network, will conduct an advanced spine assessment, order necessary diagnostic imaging, and discuss a treatment plan with you. If you require further surgical assessment, you will be offered an appointment the next available surgeon or a preferred surgeon.
Will all patients be referred to the Practice Lead?
No, only a small number of patients will be referred from the APP to the Practice Lead. As part of the assessment, the APP and the patient will collaboratively determine a need for further consultation.
Will my primary care provider be informed about my assessment(s)?
Yes, your primary care provider will be sent a consultation summary after each assessment results, which will include your self-management plan, next steps, and any required follow-up appointments. For some patients, the APP may contact your Primary Care Provider directly to discuss the assessment.