Low back pain (LBP) is among the most common reasons to visit a physician and up to 25% of Americans report an incidence of back pain within the previous three months. Combined direct and indirect costs for LBP are between $85 billion and $238 billion. While the majority of LBP episodes will resolve within 2-4 weeks, 25% of patients will experience recurrent episodes within one year and the prevalence of chronic LBP is on the rise. Low back pain can be accompanied by psychological distress, risk of persistent pain and disability. The need for new strategies to treat LBP should be a priority as healthcare costs are rising.
New research is surfacing about low back pain. The latest emerging research actually suggests that people with acute non-specific low back pain have better results if they are seen by a physical therapist earlier rather than later. Another key factor to help patients with LBP is adherence with physical therapy treatments. It is not enough to show up for one visit. Patients need to come to physical therapy regularly in order to reduce adverse events with low back pain.
In the past, the first line of treatment for low back pain been has been opioids and scanning, such as an MRI or CT scan, which can lead to high costs, adverse events, and increased risk of chronicity. Research has found cost savings when referrals to physical therapy occur early in the care process for patients with acute LBP. Patients who were seen by a physical therapist within nine days of their incident for a total of about seven visits had a decreased likelihood of receiving advanced imaging, spinal injections, lumbar spine surgery, or opioid use. Total costs were on average $1200 lower for patients receiving early care when compared to a patient receiving delayed physical therapy.
Adherence is also an important factor when looking at treating LBP. Patients who only showed up for one visit were more likely to have adverse effects than patients who adhered to physical therapy for six visits. Adherent patients paid $300 less than the non-adherent group for overall physical therapy treatment. Adherent patients also paid $350 less for prescription medications.
So what do these numbers mean? A look at the overall cost and burden of patients with LBP indicates that we need to be better at treating these patients. Studies show that patients who were treated with early and consistent physical therapy had a 60% lower total cost compared to patients who did not receive early care. This can save our medical system a significant amount of money as well as save the patient out-of-pocket cost.
Patients with low back pain still need to see their primary care physician first to make sure there is not an underlying cause to the low back pain; such as cancer, kidney stones, bladder infection, etc. Once the patient has been cleared from any non-medical issue, physical therapy can be started.
There is a common fear that physical therapy can make LBP worse. As more research arises proving that physical therapy is beneficial for the treatment of LBP this fear should decrease. Physical therapists are trained professionals who understand the musculoskeletal system very well. Physical therapists want the patient to return to their fullest potential and will help in any way possible to achieve that goal.