Medical Professionals

Direct Referral Information

• Non-spinal causes (vascular, neoplastic, gi) are excluded
• Clinical picture
• MRI
• Off antiplatelet drugs – 10 days
• Off anti-Xa factor drugs – for 3 days
• Off warfarin – inr <1.3
• No infections
• After flu-like symptoms — should be well for at least 2 week

Email: info@dublinpainclinic.ie

Low Back Pain Management Pathway- 3 steps

Step 1: RED FLAGS (rule out in history and examination) 

• Infection
• Fracture
• Malignancy
• Cauda Equina Syndrome (bowel/ bladder dysfunction, saddle anesthesia)

•  In case any Red flag present Refer to emergency care.
• Observe for symptoms and signs as following:
  (Fear avoidance, feel unsafe, worrying thoughts, hopelessness, helplessness, depressed or anxious).
• If present go to step 3.

Step 2: Absence of above symptoms or signs               

• Medications + Self-Management with an ongoing evaluation if unresponsive in two weeks go to step 3.

Step 3: Presence of the above symptoms and signs

• Refer to Pain Management Service which includes pain medicine, physiotherapy based rehabilitation and psychology.