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Tony T. Ton-That, M.D., LG Health’s Medical Director for Spine and Low Back Pain, will lead implementation of a new protocol for treating low back pain.

As a physiatrist, Tony T. Ton-That, M.D., takes a team approach to healthcare.
Now, Dr. Ton-That, LG Health’s new Medical Director for Spine and Low Back Pain, will work with primary care, urgent care, occupational medicine, workers’ comp and other providers throughout the health system to create a standardized approach to treating low back pain.
“Currently, there’s a lot of fragmentation, with no standard treatment plan in the community,” he said. “Low back pain is the most common complaint for people who visit a primary-care provider. The costs are amazing, from unnecessary MRIs and CT scans to costly invasive procedures.”
Dr. Ton-That comes to LG Health after 13 years in private practice at Lancaster NeuroScience and Spine Associates. The physician, who also is trained in acupuncture for pain management, will begin seeing patients at the Suburban Outpatient Pavilion this spring.
Physiatrists lead a multidisciplinary approach to supporting patients after a trauma, stroke, surgery or other disability. This includes physical, occupational and speech therapy, as well as social services and family support.
The new low back pain treatment protocol is designed to provide a high-quality, cost-effective, evidence-based standard of care that will reduce opioid drug prescriptions and unnecessary invasive treatments, medical appointments and imaging services, as well as related costs.
In the past, many patients with acute low back pain – defined as lasting three or four weeks, or developing after surgery -- were given narcotics and sent home to rest, Dr. Ton-That said. Now, the patient will see a physical therapist to learn an exercise program to implement at home.
Early intervention keeps pain from worsening and also contains costs, he said. (He notes that patients with certain red flags will be sent for imaging or a surgical consult.)
“Now research indicates that early physical therapy is the key,” Dr. Ton-That said. “We want to get patients active and moving and back to a good quality of life, so they don’t develop chronic pain.”
If the issue isn’t resolved with physical therapy, the patient receives further evaluation and care, which may include injections, medication or cognitive behavior treatment. Treating low back pain with opioid medications  is not recommended, Dr. Ton-That said.
Imaging generally is not beneficial for patients with unremarkable medical histories and no red flags, he said. Physical therapy is the initial treatment recommendation for acute musculoskeletal myofascial pain.
“If the patient goes through treatment and the pain persists, or they develop neurological deficits, such as progressive weakness and numbness, then they might need more advanced imaging to identify the problem,” he said.
Dr. Ton-That is meeting personally with providers to explain the new protocol, and guidance for EPIC is being developed. He encourages providers to contact him by email with questions.

“When you evaluate and examine a patient, look at them as a whole person,” he said. “Ask them about their goals. This helps you connect with the patient, and achieving those goals will increase patient satisfaction.”

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