Low back pain patients who receive physical therapy treatment within 3 days use fewer opioids and incur lower healthcare costs, suggest researchers from the University of Central Florida (UCF).
Early physical therapy treatment also lowered the need for advanced imaging, spinal injection, emergency department visits, and spine surgery, the researchers continue, in their study published recently in Physical Therapy.
“Low back pain is the cause of significant pain, disability, and loss of productivity,” says Xinliang Liu, an assistant professor in the Department of Health Management and Informatics at UCF and the study’s lead author, in a news story from the Orlando Sentinel. “Decisions about treatment have important implications for the health-care industry.”
In the study, Liu and colleagues analyzed the data for 47,000 patients who were newly diagnoses with low back pain. About 6,700 of these patients were treated with physical therapy. The data was from a large commercial health insurance claims database in New York State, which captured about 10% of the state’s total population younger than 65.
An analysis of the data suggests that among the newly diagnosed patients who got physical therapy, those who had the therapy within 3 days of diagnosis had the lowest need for imaging, opioid medications, specialist visits, and surgery. Those who received physical therapy after 15 days had increased use and cost of health care, according to the news story.
The study adds to the body of research that shows earlier intervention with physical therapy benefits most patients with low back pain, but it also further fuels controversies around the issue, the story continues.
After reviewing the study, Dr Philip Meinhardt, an orthopedic spine surgeon at Jewett Orthopaedic Clinic in Orlando comments that, “What the study really does, is echo what we’ve known for a long time: Acute lower back pain is extremely common. Even though when these episodes are very severe, they’re usually self-limiting problems and usually resolve within six weeks.”
Meinhardt adds in the news story that he typically gives his patients anti-inflammatory drugs, tells them to remain mobile, and advises against bed rest. If after a few weeks these interventions don’t work, then he turns to physical therapy.
“I don’t have anything against physical therapists. We have many physical therapists here in Jewett,” Meinhardt shares. “The biggest thing is not the getting them in [to see a physical therapist]. It’s not to overtreat low back pain.”