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:
    • 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.

  • 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.

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

Health pathways

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