Early physical therapy for low back pain reduces costs and resources
A study in the scientific journal BMC Health Services Research has shown that early and guideline adherent physical therapy following an initial episode of acute, non-specific low back pain (LBP) resulted in substantially lower costs and reduced use of health care resources over a two-year period.
Physical therapist researcher John Childs and co-workers analysed 122,723 patients who saw a primary care physician following an initial LBP episode and received physical therapy within 90 days. Of these, 24 per cent (17,175) received early physical therapy (within 14 days) that adhered to guidelines for active treatment. During a two-year time period, these patients made significantly less use of advanced imaging, lumbar spinal injections, lumbar spine surgery and opioids than did patients in other combinations of timing and adherence. Early physical therapy patients also had 60 per cent lower LBP-related costs as compared with 33.5 per cent (23,993) of patients who had delayed and adherent physical therapy (between 14 and 90 days). Patients received physical therapy within the Military Health System, one of the largest single payer health systems in the USA.
Clinical guideline recommendations in military and civilian settings are to avoid opioids and advanced imaging procedures as a first-line of treatment but research done mainly in civilian settings reveals that clinical practice is inconsistent with these recommendations.
Childs, J.D., Fritz, J.M., Wu, S.S., et al. (2015) Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv. Res. 15, 150. doi: 10.1186/s12913-015-0830-3