Effects of musculoskeletal expert input on low back pain outcomes: A randomised controlled trial.

Study Summary

101 adults with low back pain (LBP) referred for neurosurgical consultation were randomized to receive chiropractor-led triage recommendations communicated to the neurosurgeon or usual neurosurgical care without access to these recommendations. All patients underwent a standardized chiropractic assessment before their neurosurgical consultation. The primary outcome of interest was current back pain intensity at 3 months, measured using the 11-point Numerical Rating Scale (NRS-11). Secondary outcomes included leg pain intensity, LBP-related disability measured using the Oswestry Disability Index (ODI), quality of life, perceived recovery, medication use, diagnostic investigations, and health-care utilization. Outcomes were assessed at 1 week and 3, 6, and 12 months. Overall, the results revealed that statistical equivalence in back pain intensity could not be established, although between-group differences were generally small and below clinically meaningful thresholds. Most clinical outcomes and health-care utilization measures were comparable, except for fewer general practitioner consultations at 6 months in the intervention group. These findings suggested that incorporating chiropractor-led triage recommendations into neurosurgical consultations had limited effects on clinical outcomes and care trajectories.