Physical therapists offer low-cost solution to high-cost expenditures for acute low back pain

August 12, 2008

The American Physical Therapy Association (APTA) concurs with findings from a recent study published in Spine (Volume 33, Number 16) demonstrating that active physical therapy for patients with acute low back pain is associated with better clinical outcomes, decreased use of prescription medications, MRI and epidural injections, and lower healthcare costs than passive physical therapy.

For pain of a 'mechanical' origin such as low back pain, hands-on therapy to mobilize the spine and exercises designed to alleviate low back pain have been shown to be particularly effective and have long-lasting effects on patients. According to the study's lead researcher and APTA member Julie Fritz, PT, PhD, ATC, Clinical Outcomes Research Scientist at Salt Lake City's Intermountain Healthcare and associate professor at the University of Utah, "Physical therapists are often one of the first health care providers that patients with acute low back pain encounter - whether they are referred by medical doctors or visit them directly - which offers evidenced-based PTs a tremendous opportunity to help patients recover."

Physical therapist management is a low-cost, high-value alternative to medication and surgery to deal with certain musculoskeletal pain. According to Fritz, "Considering that low back pain will affect between sixty and eighty percent of Americans during their lifetime, the potential cost savings of an early, effective intervention to prevent individuals from progressing to chronic disability may be considerable."

The study consisted of a retrospective review of 471 patients, ages 18-60. One hundred thirty-two patients (28 percent) received active physical therapy (involving a high percentage of active exercise) and 339 (72 percent) received non-adherent care (defined as involving greater than 25% passive treatments such as hot/cold treatment, ultrasound, and electrical stimulation).

Patients receiving active physical therapy experienced greater improvement in function, decrease in pain intensity, received fewer physical therapy visits, had a shorter duration of care, incurred lower charges for physical therapist care, and were more likely to experience a successful physical therapy outcome. Among patients receiving non-adherent or passive care, the rate of additional healthcare utilization (including prescription medication, office or emergency room visits, inpatient/surgical services, and diagnostic procedures) was 65.8 percent, compared with 55.3 percent among patients receiving adherent care.

"The findings from this research can be applied throughout all fields of medicine, not just to physical therapy," said physical therapist and APTA member Gerard Brennan, PT, PhD, Director of Clinical Quality and Outcomes Research at Intermountain Healthcare, who was one of the lead researchers on the study. "If all physicians and therapists adhere to their field's recommended clinical practice guidelines, they, too, should see a decrease in subsequent health care utilization. It is our hope that this research will help physical therapists - as well as all medical professionals - do their job more effectively," he added.

Physical therapists are health care professionals who diagnose and manage individuals of all ages who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

Source: American Physical Therapy Association