Intended for healthcare professionals

Rapid response to:

Clinical Review

Low back pain

BMJ 2004; 328 doi: (Published 06 May 2004) Cite this as: BMJ 2004;328:1119

Rapid Response:

Re: Everyday in the GP surgery


Effective, efficient care for patients with acute low back pain is

Following on from the success of a three year pilot into the
practicalities of implementing the then new RCGP guidelines, Greater
Glasgow Health Board put their money where their mouth was and created the
Greater Glasgow Back Pain Service in April 2002.

This is a city-wide service lead by thirteen clinical specialist
physiotherapists strategically placed throughout the city. Any patient
with a 6 week or less history of low back pain can access the service
either through self-referral or via their GP. Patients with nerve root
symptoms are seen within one week and all others within two.

The physiotherapist assesses using a biopsychosocial model and treats
according. If indicated, the physiotherapist can refer directly for MRI,
dexa scan, bone morphology, neuro or othopaedic opinion. This ensures a
smooth patient pathway of care.

A recent audit of MRI/ortho referrals has revealed a marked
improvement in the quality of referrals for further investigation and a
resultant positive impact on both orthopaedic and radiology resources.

Uniquely, where psychosocial issues are affecting recovery, there is
direct access to clinical psychology. Physiotherapy and clinical
psychology work together to provide an 'enhanced back class' for those
people requiring additional support in managing their back problem.

Patients are offered and receive a 'patient-centred' service based on
the needs of the individual, ensuring a smooth, efficient and effective
pathway of care.

Competing interests:
None declared

Competing interests: No competing interests

23 July 2004
Susan Morison
Clinical Physiotherapy Specialist
Greater Glasgow Back Pain Service, RUtherglen Primary Care Centre, Rutherglen, G73 2PQ