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Link Between Early Physical Therapy Intervention for Treating Low Back Pain and Decreased Long Term Healthcare Costs

By, Dr. Dimitri Baldwin

Low back pain

As a Physical Therapist, chronic low back pain is a condition we typically see on a daily basis. According to the National Institute of Health, 80% of adults experience some form of low back pain in their lives. It is reported that about $85 to $238 billion is spent yearly on healthcare-related costs associated with back pain. These costs often include Doctor visits, diagnostic tests, injections, medications, and surgeries. And with the increasing rise of opioid addiction, the medical community is investigating alternative means to effectively manage pain. Typically, when someone experiences acute low back pain, their symptoms may spontaneously resolve within a few weeks, depending on the cause of their pain. But for some others, back pain may linger on and become very debilitating.

What does the research say?

In a study published by BMC research services in 2015, it compared the early intervention of PT for patients with acute low back pain to those who did not immediately begin PT, and then analyzed the subsequent healthcare costs between both groups over a course of 2 years. This study was performed by the Military Health System, which is the health care system that provides coverage to over 10 million military personnel and their family. Within the military, chronic back pain is actually the leading cause of military medical discharge. Opioid use is also very high within this group. In this study, patients who started physical therapy within the initial 14 days of developing of back pain (early intervention group) were compared with patients who sought treatment 14 to 90 days following the onset of pain(delayed therapy group). The study followed these two groups for 2 years to assess the related health care costs which followed within this 2 year period. Researchers found that healthcare costs were significantly different be-tween both groups. The patients who received early intervention had significantly lower utility costs of lumbar spinal injections, lumbar spine surgery, the use of opioids and advanced imaging (X-rays, MRIs). In fact, a recent study found that patients who received MRI imaging first compared to those who received physical therapy first for their low back pain spent an average of $4793 more toward their medical costs. This suggests that immediately seeking physical therapy is effective in managing pain long term and reducing health care costs.

Why use a Physical Therapist?

A physical therapist is skilled in identifying the source which contributes to low back pain. There can be several reasons for low back pain. Some of the more common conditions include: degenerative disc disease, lumbar stenosis, herniated disc, arthritis, osteoporosis, and lumbar instability. In addition to identifying the source, a physical therapist can also identify when further testing or referral to another specialist is indicated. Furthermore, a physical therapist is also skilled at developing an individualized treatment plan which is specific to your condition, often times, without the need for expensive surgery or medication. If you are experiencing pain or want to understand why, give us a call today to see how we can help. No referral or MD prescription is needed. Our specialists will be able to help guide you back to recovery.

Childs JD, Fritz JM, Wu SS, et al. Implications of early and guideline adherent physical therapy for low back pain on utiliza-tion and costs [erratum in: BMC Health Serv Res. 2016;16:444]. BMC Health Serv Res. 2015;15:150

Frogner BK, Harwood K, Andrilla CH, Schwartz M, Pines JM. Physical therapy as the first point of care to treat low back pain: an instrumental variables approach to estimate impact on opioid prescription, health care utilization, and costs. Health Serv Res. 2018 May 23 [Epub ahead of print]. doi: 10.1111/1475-6773.12984

Kosaku A, Heller D, Hazlewood D, Sharmaa N, Santosa M. Is spinal mobilization effective for low back pain?: A systematic review. Complementary therapies in Clinical Practice. Vol 34, Feb 2019; 51-63

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