Early PT Reduces Costs in Military Low Back Pain

SAN ANTONIO — Early, guideline-adherent physical therapy following an initial episode of acute, nonspecific low back pain (LBP) resulted in substantially lower costs and reduced use of healthcare resources over a two-year period.

That’s according to a study published in BMC Health Services Research. The study team led by researchers from the U.S. Army-Baylor University Doctoral Program at Fort Sam Houston, TX, analyzed 122,723 patients who went to a primary-care physician following an initial LBP episode and received physical therapy within 90 days.1

Of these, according to the results, 24% (17,175) received early Military Health System physical therapy within 14 days that adhered to guidelines for active treatment. Over two-years, those patients made significantly less use of advanced imaging, lumbar spinal injections, lumbar spine surgery and opioids than did patients in other combinations of timing and adherence.

The study found that early physical therapy patients also had 60% lower LBP-related costs as compared with 33.5% (23,993) of patients, who had delayed and adherent physical therapy of between 14 and 90 days.

“Physical therapy as the starting point of care in your low back pain episode can have significant positive implications,” explained lead author John D. Childs, PT, PhD. “Receiving physical therapy treatment that adheres to practice guidelines even furthers than benefit.”

While clinical guidelines in military and civilian settings recommend avoidance of opioids and advanced-imaging procedures as a first line of treatment, that often isn’t followed. Childs pointed out that this study’s results extend the findings from civilian settings by demonstrating an association between early guideline adherent care, costs and use of healthcare resources in a single-payer health system.

  1. Childs JD, Fritz JM, Wu SS, Flynn TW, Wainner RS, Robertson EK, Kim FS, George SZ. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res. 2015 Apr 9;15:150. doi: 10.1186/s12913-015-0830-3.
  2. PubMed PMID: 25880898; PubMed Central PMCID: PMC4393575.

Comments (1)

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  1. Emilia Green-Riviere says:

    I’m a certified Orthopaedic Nurse practitioner who is a very strong believer of PT. It is amazing to see the difference between patients who adhere to their PT program after joint replacement especially total knee replacements compared to those who did not. The difference is good ROM as opposed to subpar ROM.

    I currently work in chronic pain and there is also a noticeable difference noted with patient presenting with pain (neck, shoulder, back, LE pain, etc.) Those who comply and do PT will note a reduction in their pain and increase ROM/function. However, the importance is ensuring that they understand that physical exercises with weight reduction/maintenance is for life and not just for the moment when they worked with PT.

    Emilia Green-Riviere, DNP,RNP,PNP,CNS,ONP-C

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