Evidence and clinical practice guidelines support the use of conservative care, such as chiropractic and/or physiotherapy, as first-line treatment (even before meds) for a number of MSK conditions, including acute and chronic low back pain. Studies have actually demonstrated that the inappropriate use of pain meds, imaging and surgical referrals all lead to worst outcomes long term. Inappropriate (patient is not a candidate) referrals to imaging or surgery can seriously hinder a patient’s prognosis – and should be done carefully and mindfully. For example, when you look at surgical waitlists in Ontario, 9 out of 10 are typically not candidates, however they wait 6-8 months to be turned away…and now are chronic, etc.
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