Q&A

When does back pain qualify as chronic back pain? [back to top]

Chronic back pain is defined as back pain that persists after three months of onset.

If chronic back pain fails to resolve within this time frame, it is generally unlikely that it will resolve spontaneously without some clinical intervention. The reason for failure of spontaneous improvement is because the natural tendency of people with chronic back pain is to reduce physical activity. This results in further deconditioning of spinal core muscles, ensuring that the underlying causes of chronic back pain remain untreated, perpetuating the symptom complex clinically recognized as chronic back pain. [ back to top ]

How long will it take for the Chronic Back Pain Clinic treatment program to produce results?

It is the policy of the Chronic Back Pain Clinic that each patient must demonstrate a measurable improvement in level of comfort WITHIN 14 DAYS OF THERAPY.

If our therapeutic intervention fails to produce this result, we will take whatever measures required to ensure referral of our patients to a higher level of care for additional investigations and treatment to make certain that whatever can be done -- will be done![ back to top ]

Do I need a referral for consultation at the Chronic Back Pain Clinic?

The Chronic Back Pain Clinic does not require a referral to admit patients to our clinical care program.

Although the Chronic Back Pain Clinic accepts referrals from physicians, physiotherapists, chiropractors and massage therapists from areas throughout B.C., we will evaluate all patients who present to our clinic for suitability in enrolment in our therapeutic program.[ back to top ]

Is there a waiting list for consultation at the Chronic Back Pain Clinic?

Because most therapeutic treatment programs in the Chronic Back Pain Clinic are successfully completed within eight weeks, new spots for entry into the Clinic’s therapeutic Chronic Back Care program are always opening up. We almost always are able to accommodate new patients within one to two weeks following request for consultation.[ back to top ]

What are the costs of care to attend the Chronic Back Pain Clinic?

All initial consultation costs are covered by the Government Medical Services Plan (MSP) of British Columbia. Patients arriving from other provinces in Canada are also covered through the reciprocal billing program that the British Columbia Government Medical Services Plan has with other Canadian provincial counterparts (exception is Quebec).

All investigative procedures including X-rays, CAT Scans, MRIs, bone scans and blood tests may also be ordered through the Government Medical Services Plan (MSP) without cost to the patient.

Therapeutic services including manual therapy and some medical procedures are also covered under the umbrella of the Government Medical Services Plan (MSP)coverage.

Other medical therapies including Medical Acupuncture, Prolotherapy and Kinesiology Spinal Conditioning Sessions may not be covered by these agencies, but may be covered by extended health insurance policies that may be covered through your employment or by having purchased these extended coverage policies yourself.

Some specialized tests may take weeks to months to schedule within the Government Medical Services Plan system. Under these circumstances patients may opt to have the tests ordered privately --- arrangements can normally be made within one to two weeks of request. This also applies when a need is determined for referral to specific Medical Specialists or Surgeons. [ back to top ]

How is the Chronic Back Pain Clinic different from other treatment centers managing chronic back pain?

Many different therapists including physiotherapists, chiropractors, massage therapists and exercise training centers are involved in the treatment of chronic back pain and effectively manage uncomplicated cases of chronic back pain. Most therapists offer these services in conjunction with inclusive therapies directed towards general musculoskeletal disorders.

The Chronic Back Pain Clinic specializes only in management of chronic back pain and most commonly sees complicated cases which have not responded to the usual therapies. Our referral base therefore is generally comprised of those cases which have not responded successfully to the usual modalities of care offered by other therapeutic centers.

The Chronic Back Pain Clinic is not committed to any specific modality of therapy and considers and uses ALL of the accepted medical therapies proven in producing positive results in the management of chronic back pain.

It has been repeatedly demonstrated in the medical literature that the treatment of chronic back pain is more effective when more than one modality of therapy is offered in the therapeutic regimen. It is also recognized that what may work for one patient may not necessarily work for the next.

Another way of stating this -- "If the only tool you have in your bag is a hammer, everything will start looking like a nail."

It is important that treatment programs are modified to tailor the needs of each individual patient --- rather than assigning all chronic back pain case presentations into the same treatment regimen.[ back to top ]

What treatments are provided by the Chronic Back Pain Clinic?

The Chronic Back Pain Clinic offers a wide mix of therapeutic services in the management of chronic back pain, all of which have been medically proven to be effective therapies in managing individual chronic back pain complaints.

During the course of your treatment in the Chronic Back Pain Clinic, depending on the initial medical examination and diagnosis, you can expect one or more of the following therapies to be used in the management of your chronic back pain problem.

• Spinal Manipulation and Other Manual Therapies
• Neural (Medical) Acupuncture
• Prolotherapy
• Kinesiology Spinal Conditioning Sessions [ back to top ]

More can be learned about these modalities of therapy by following this link.

I have osteoporosis and osteoarthritis. Can my chronic back pain still be helped?

Osteoporosis and osteoarthritis often coexist with chronic back pain, however, in most cases they will not necessarily be the underlying contributory cause of the chronic back pain.

Osteoarthritis which represents a natural wearing out process of the joint cartilage beginning with middle-age, exists in most people after the age of 40. So it is very likely that most people in this age group who have chronic back pain will also have evidence of osteoarthritis on spinal x-rays.

However it is very important to know --- only 30% of people with osteoarthritis will have significant pain, so one does necessarily imply the other.

Osteoporosis on the other hand, describes the loss of calcium and the weakening process that occurs in bone, mostly occurring in people after the age of 50. It is most common in postmenopausal women but may affect men as well.

Again, osteoporosis is a silent disease and not generally associated with chronic back pain unless there are accompanying compression fractures which may occur following an injury, but may also occur spontaneously in the absence of any trauma.

In most cases, a diagnosis of osteoporosis comes as a complete surprise to the patient after a screening test has been ordered by a medical doctor.

The answer is yes --- treatment of chronic back pain can be effectively undertaken even if there is an underlying diagnosis of osteoporosis or osteoarthritis.[ back to top ]

For More Information on Osteoporosis and Osteopenia ... Follow This Link . . .

Will the Chronic Back Pain Clinic send a report to my doctor?

All patients who are referred to the Chronic Back Pain Clinic by their attending family physician will have an initial consultation report prepared by the Chronic Back Pain Clinic which is sent to the attending referral doctor. The cost of this consultation report is included in the fee paid by the Government Medical Services Plan (MSP) when patients are referred to our care by their attending family physician. Further follow up reports are prepared as necessary depending on the progress of each individual patient.

For all non-physician referred patients, upon request by the patient, consultation reports will be prepared for their attending physicians. This ensures that each individual's personal medical file will be appropriately updated in their home clinic. The costs of preparation of these consultation reports are not covered by the Government Medical Services Plan (MSP)and will be charged to the individual patients. [ back to top ]

What can "I DO" to help my chronic back pain?

This is an excellent question and points to the bottom line in the treatment management of chronic back pain. Following an accurate diagnosis of the underlying cause of chronic back pain in each individual patient, appropriate therapies initially directed towards the treatment of chronic back pain will likely be very helpful in addressing the acute spasm of the supporting muscles, improving the range of motion of the vertebral segments and in general lessening the pain and improving the function of spinal movement.

These therapies properly applied in the initial stages of treatment of chronic back pain are often described as "passive therapies" and when effective will almost always result in symptomatic improvement and lessening of pain.

Without an active program designed to improve the core strength of the supporting musculature of the spinal column and correction of postural alignment however, there is little hope that the gains of this initial therapeutic intervention will be sustained in the long run.

Working with the Clinic’s trained kinesiologist and diligent attention to the prescribed home exercise programming is critical to achieve this result of long-lasting relief. This is the crucial part to every treatment management program and describes what every patient must "bring to the table" to sustain their improvement and prevent reoccurrence of the underlying original injury responsible for the chronic back pain syndrome.

Most importantly, this is what turns "fear into confidence" by empowering each patient with the tools to effectively manage their own treatment of chronic back pain. [ back to top ]