Initiating physical therapy at the onset of low back pain is better than ‘wait and see’ approachApril 12, 2016
Lower back pain is a condition that plagues an astonishing 61 percent of Americans, according to a 2012 survey by the American Physical Therapy Association. For years, many people who visit their physician while experiencing back pain have been told to follow the “wait and see” approach to monitor their symptoms before taking action. The “wait and see” approach may involve taking anti-inflammatory medications to temporarily relieve pain while monitoring symptoms. This delayed referral often has patients starting physical therapy 15-90 days after onset of pain, which is valuable recovery time.
Current research shows that this approach may not be the most effective. A systematic review of back pain patient outcomes illustrates that early initiation of physical therapy may decrease health costs and improve overall outcomes. Back pain treatment by a physical therapist can include manual therapy and manipulation, strengthening and flexibility exercises, education regarding proper lifting, bending, and sitting habits, and passive modalities such as heat, ice, and electrical stimulation to the affected area. By starting physical therapy at the onset of musculoskeletal pain, the patient may be able to avoid pain relief medications, painful injections, expensive advanced imaging, and invasive surgeries. Initiating physical therapy treatment early saves patients time and money, due to the high cost of the previously mentioned treatments and modalities.
Another study published by Health Services Research illustrates that using advanced imaging as a first step in management strategy leads to overall higher healthcare costs by an average of $4,793 (HSR 2015). Physical therapy also offers a treatment plan with far less risk than invasive surgical procedures. This study’s data illustrates that surgery and physical therapy can have equal success outcomes, making physical therapy a less risky and more cost effective first option.
While a physician may instruct their patient to “wait and see,” patients should be aware that New Jersey is a direct access state for physical therapy. This means that a patient does not need a referral or prescription from a doctor in order to receive physical therapy. The patient can contact a physical therapist directly to set up an appointment, be evaluated, and initiate treatment. Patients should feel comfortable discussing the option to start physical therapy sooner with their primary care provider.