Neck pain

Emergency referrals

All urgent cases must be discussed with the on call Neurosurgery Registrar. Contact through Royal Brisbane and Women's Hospital (07) 3646 8111 to obtain appropriate prioritisation and treatment.

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

Neck pain with progressing motor radiculopathy and/or cervical myelopathy
Neck pain due to tumours or infection
Neck pain with red flags

Presence of red flags

Age (at onset) < 16 or > 55
Motor deficit e.g. foot weakness
Recent significant trauma
Unexplained weight loss
History of cancer
History of IV drug use
Prolonged use of corticosteroids
Severe night pain
Infection/fever

Category 2

Appointment within 90 days is desirable

Neck pain with radiculopathy

Category 3

Appointment within 365 days is desirable

Persistent neck pain ≥ 8 weeks, referred to the arm without neurological deficit, despite maximal medical management

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

Monitor neurological function
Neck pain associated with referred arm pain ≤ 8 weeks:
- physiotherapy
- activity modification
- analgesia & NSAIDs
- education
- heat/gentle massage
Neck pain associated with referred arm pain ≥ 8 weeks refer to physiotherapy screening clinic
If infection or malignancy is suspected:
- FBC CRP ESR
- serum calcium and phosphate, serum protein +/- electrophoresis
Consider radiological investigations if symptoms are progressive and/or > 8 weeks e.g. CT and MRI

NB: Neck pain with red flags – if clinical circumstances indicate the patient requires immediate treatment, refer to emergency.

NB: Many category 2 and 3 patients referred for a surgical opinion do not require surgery or a surgical opinion. Evidence demonstrates that non-surgical management is as effective for a number of spinal conditions. Where services are available, category 2 and 3 patients will initially be assessed / reassessed and case-managed by an expert musculoskeletal physiotherapist. Outcomes from this or subsequent review assessments may include discharge, provision of appropriate non-surgical management plans, discussion or appointment with a spinal surgeon.

Referral requirements

A referral may be rejected without the following information.

Essential referral information

Presence and duration of neurological symptoms and signs
CT/MRI results
FBC ESR CRP results
Conservative measures trialled

Additional referral information (useful for processing the referral)

Serum calcium, phosphate, serum protein +/- electrophoresis when indicated

Out of catchment!

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Clinical Modifiers (where relevant)

Impact on employment
Impact on education
Impact on home
Impact on activities of daily living
Impact on ability to care for others
Impact on personal frailty or safety
Identifies as Aboriginal and/or Torres Strait Islander

Reason for Referral (essential)

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can’t order, or the patient can’t afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Clinical Information (essential)

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient’s Demographic Details (essential)

Full name (including aliases)
Date of birth
Residential and postal address
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander

Referring Practitioner Details (essential)

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature

Other Information (where relevant)

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Send referral

Hotline: 1300 364 938

Fax: 1300 364 952

Electronic: eReferral system

Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034

Health pathways

Access to Health Pathways is free for clinicians in Metro North Brisbane.

For login details email:
healthpathways@brisbanenorthphn.org.au

Locations

Royal Brisbane and Women's Hospital