Tony T. Ton-That, M.D., of LG Health Physicians Pain Management, evaluates and treats patients for acute back and neck pain with non-opioid alternative treatments, including physical therapy, joint or trigger point injections, and acupuncture. He also performs diagnostic studies, including EMG and nerve conduction studies, and collaborates with fellow physicians for other appropriate procedures.
In its first two years, LG Health’s acute low-back pain protocol has shown significant progress toward achieving its three major goals.
Tony Ton-That, M.D., LG Health Medical Director of Spine and Low Back Pain, said the three-year project establishes a systemwide standard of care that reduces opioid prescriptions, unnecessary invasive treatments, medical appointments and imaging services, as well as related costs.
While many patients with low-back pain previously received opioids or other addictive medications right away, the new protocol calls for a “fast track” to physical therapy instead.
“We want to aggressively treat acute low-back pain patients with non-aggressive treatments,” Dr. Ton-That said. “Research shows that rapid access to physical therapy and other evidence-based treatments can successfully treat pain without opioids.”
So far the low-back pain protocol has:
Reduced opioid prescriptions. Previously 50 percent of patients treated in the Emergency Department for acute low-back pain left with a prescription for an opioid medication. That number has dropped to 10 percent. LG Health Physicians primary-care practices previously prescribed opioids to 40 percent of low-back pain patients; that number has declined to 20 percent.
Increased referrals to physical therapy. The creation of a “fast track” from the ED or primary-care practice to physical therapy has increased PT volumes by 30 percent.
Decreased unnecessary imaging services. Imaging is costly and often not necessary to diagnose acute low back pain. Fewer low-back pain patients now receive MRI or CT scans.
Low-back pain is the leading cause of disability in the United States, accounting for nearly 15 million medical visits and $25 billion in health-care spending annually.
LG Health’s protocol utilizes additional evidence-based treatments, including localized injections, non-addictive medications that target nerve pain and inflammation, cognitive behavioral therapy and acupuncture. Education of patients and providers is critical to the project’s success, Dr. Ton-That said.
In 2016, LG Health’s low-back pain protocol won the Hospital and Healthsystem Association of Pennsylvania’s Optimal Operations Award.