Low back pain (LBP) has been shown to be one of the most common reasons to seek healthcare, lost work time among working-age adults, and the cause of disability. Childs et. al. (2015) found that combined direct and indirect costs for LBP are reported to be between $85 billion and $238 billion dollars.

Since LBP has become so common, what are we doing when low back pain occurs? Most commonly people:

• Will “wait it out” in hopes their back pain will go away.
• Go to the Emergency Department.
• Go to their primary care provider.  

Unfortunately, additional time without treatment has been seen to dramatically increase utilization cost of LBP (Gellhorn, et.al, 2012; Childs, et. al, 2015). Individuals who received early physical therapy spent $1202.29 lower on average due to a reduction in advanced imaging, surgery, spinal injections, and opioid use compared to patients who delayed physical therapy (Beattie, 2016; Childs, et.al, 2015; Gellhorn et al. 2012).

Why are we not taking advantage of skilled physical therapy? 

With several studies finding a positive association between reducing cost, lost time, and pain with early physical therapy intervention, why are more people not taking advantage of physical therapy? 

Many may not know that you are able to seek skilled physical therapy without referral. 

• Colorado does not require a referral to see a physical therapist; however, some insurance plans still require a referral of physician approval to pay for care such as Medicare, Medicaid, Tricare, and Kaiser. 

Fear of treatment / Pain

• Clinical Practice Guidelines for Low Back Pain is a guide on how to treat LBP. This guide outlines the best treatment for acute low back pain and those treatments are: manual therapy (thrust manipulation), trunk coordination, strength endurance exercises, and patient education.
• Increased activity is superior to prolonged rest when trying to reduce LBP. As we rest, we weaken. Weakness exacerbates symptoms and prolonges recovery. 

This review shows that early treatment with skilled physical therapy utilizing manual therapy, core strength, stabilization and patient education along with increased activity can reduce the time and cost of acute low back pain. Come see Synergy Physical Therapy and Wellness as fast as you can when injured. Early treatment leads to greater success. We look forward to seeing you. 

-Dr. Michelle Perse, PT, DPT

Sources:

Beattie, P.F., (2016) The Lumbar Spine: Physical Therapy Patient Management Using Current Evidence. Current Concepts of Orthopaedic Physical Therapy (4th Edition)

Beneciuk, JM., Bishop, M.P., Kramer, C.D., Koch, W., Shepherd, M. Low Back Pain, Clinical Practice Guidelines Linked to the International Classification of Functioning Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2012; 42(4):A1-A57. Doi:10.2519/jospt.2012.42.4.A1

Childs, J.D., Fritz, J.M., Wu, S.S. et al. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res 15, 150 (2015). https://doi.org/10.1186/s12913-015-0830-3

Fritz JM, Childs JD, Wainner RS, Flynn TW. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. Spine (Phila Pa 1976). 2012;37(25):2114–2121

Gellhorn AC, Chan L, Martin B, Friedly J. Management patterns in acute low back pain: the role of physical therapy. Spine (Phila Pa 1976). 2012;37(9):775–782

Linton SJ, Hellsing AL, Anderson D. A controlled study of the effects of an early intervention on acute musculoskeletal pain problems. Pain. 1993; 54:353–359.