Early Physical Therapy for Low Back Pain Most Effective and Least Costly Option

While many patients suffering from low back pain (LBP) jump right to opioids or advanced imaging procedures for relief, researchers found that the most beneficial method is also wallet-friendly.

Lead Author John D. Childs, PT, PhD, a physical therapist researcher, and his colleagues identified 122,723 patients complaining of new LBP. Each participant consulted with a primary care physician after experiencing a pain event between January 1, 2007 and December 31, 2009 and began physical therapy no longer than 90 days afterwards.

Published in BMC Health Services Research, the team found that 24% of patients (17,175) began treatment within 14 days, called early physical therapy.

"Physical therapy as the starting point of care in your low back pain episode can have significant positive implications," Childs said in a news release.

Researchers found that after 2 years from the initial complaint, the early physical therapy patients used from opioids and other in-depth pain relieving techniques such as lumbar spinal injections, lumbar spine surgery, and advanced imaging significantly less than the others.

"Receiving physical therapy treatment that adheres to practice guidelines even furthers than benefit,” Childs explained.

In both military and civilian settings, the clinical guidelines recommend that patients should avoid opioids and advanced imaging procedures as a first-line of defense against LBP. The authors noted that guidelines for this practice in civilian cases, however, is inconsistent.

Not only did the early physical therapy group have less of a need for alternative healthcare resources, but they also proved to walk away with more money in their pockets. When compared to the 33.5% of patients (23,993) who didn’t begin physical therapy until 14 to 90 days after meeting with a physician, the early treatment group had 60% lower LBP-related costs.

"Given the enormous burden of excessive and unnecessary treatment for patients with low back pain, cost savings from physical therapy at the beginning of care has important implications for single-payer health care systems.” Paul Rockar Jr, PT, DPT, MS, president of the American Physical Therapy Association, said.

The team concluded that while future research on early physical therapy for LBP patients is needed, the results demonstrate a pattern of pain relief and lower health costs.