Back pain is one of the most common reasons Ontarians go to their local hospital emergency department (ED).

Yet most spine, muscle or joint pain can be better assessed and managed by experts outside the ED.

Chiropractic student with simulation mannikin at the Canadian Memorial Chiropractic College (CMCC)

The Challenge:

  • Every year, more than 400,000 Ontarians with spine, muscle and joint (musculoskeletal) conditions like back, neck and shoulder pain, visit the ED.¹
  • Back pain alone is the third most common reason for adults to seek emergency care.¹
  • In some cases, spine, muscle or joint (musculoskeletal) pain does require emergency care, such as a traumatic injury, or when it’s a sign of something more serious. But usually it can be better assessed and managed by experts outside the emergency department.
  • In fact, 97 per cent of patients with back pain were not admitted to hospital after waiting in the ED.²

This is an expensive approach to delivering care for Ontarians. It also increases the wait time for those who need hospital care. And limited options for hospitals to assess and treat spine, muscle and joint pain in EDs likely helps make back pain a leading reason a patient leaves hospital with a new opioid prescription.³

Visiting your local hospital emergency department may not help your back pain. You wait, are rarely admitted — creating hallway healthcare that doesn’t work for you or other Ontarians. Chiropractic care works better.

Building on Research and Results

There’s a better way to managing your back pain.

You can receive better care for drug-free (non-pharmacological) pain management, in your community and funded largely through your workplace benefits.

Plus programs that are working in Ontario, like the Primary Care Low Back Pain (PCLBP) program can be scaled up to support people who don’t have workplace benefits and can’t afford to pay for care. This program works in existing community health settings with no administrative overhead or physical infrastructure.

Together, these changes can pave the way for faster access to evidence-based, leading practice chiropractic care and the make the demise of hallway healthcare easier by addressing a leading reason for ED visits that are not helpful to patients.

Ending Hallway Healthcare

Don’t wait in your hospital emergency department to receive treatment for your back pain. Visit your local chiropractor.

For Ontarians struggling with spine, muscle and joint pain, fast access to the right care is an essential part of quality care. Right now, there are significant barriers to integrating primary health care funded through workplace benefits. Breaking down these barriers is key because most evidence-based drug-free (non-pharmacological) pain management in Ontario is provided outside the tax publicly funded health care system.

Helping patients make more effective use of available benefits would dramatically increase faster access to care, and alternatives within the provincial government funded system can be prioritized for those without available benefits.

The goal of Ontario Health Teams is to improve quality of care for patients with greater integration of all health providers, including chiropractors. Chiropractors are highly trained in the key competencies for assessing, diagnosing and managing common spine, muscle and joint-related pain. Enabling chiropractors to do more to meet patient needs will strengthen the overall quality of care available to Ontarians, while enabling doctors to respond to the diverse and growing health needs of Ontario.

Reducing Hallway Healthcare Helps Ontarians

With the creation of Ontario Health Teams by the Ontario government, there are great opportunities to give Ontarians better care. Let’s break down barriers between publicly-funded and privately-funded health care that works better for patients and Ontarians by including care options already available in the community, and reducing the need for hospital ED visits.

Results/Outcomes

Changing best practices support new approaches

A better approach to helping Ontarians manage spine, muscle and joint pain also aligns with recent changes in clinical best practice recommendations. These changes recognize growing concerns that traditional health care system approaches to back pain are potentially ineffective, and sometimes make the problem worse.

The new guidelines now agree on a biopsychosocial approach that includes patient education and optimizes non-pharmacological modalities, including spinal manipulation for back pain.4 These recommendations strongly align with the approach of chiropractic care.

Importance of improving timely access to evidence-based care

For spine, muscle and joint pain, the goal for health care modernization is more timely access in the community to evidence-based care. People struggling with acute muscle and joint pain usually want an assessment and a plan for achieving relief as soon as possible and without travelling to multiple providers. Concern about accessing the right care at the right time is heightened because the most recent Ontario evidence points to back pain being the leading reason for new opioid starts from EDs and family doctors.3

Chiropractors’ Impact

Ontario’s 5,000 Chiropractors are primary contact experts highly trained in the diagnosis, treatment and prevention of back pain and other musculoskeletal conditions that affect your spine, muscles, joints and nervous system. Chiropractors provide care to millions of Ontarians each year.

Watch for updates on this page and in the OCA members’ bulletin


[1] CIHI, NACRS Emergency Department Visits and Length of Stay, 2017-2018
[2] CIHI, NACRS Emergency Department Visits and Length of Stay, 2017-2018
[3] Burgundvaag, B. et al. (2018). Opioid prescribing and adverse events in opioid-naïve patients treated by emergency physicians versus family physicians: a population-based cohort study. CMAJ Open, 6(1).
[4] National Pain Centre, Lancet, ACP, Lancet, Health Quality Ontario (HQO)