More and more studies point to the way to reduce the cost of Low Back Pain (LBP) is to seek physical therapy first (before expensive imaging or injections)(1-4,6). Thankfully more and more insurances are mandating a course of PT before any imaging or injections. I know some reading do not understand this or may be irked by having to wait. HOWEVER, in most cases, low back pain will resolve without the unnecessary expenses those medical options come with (5).

The other important piece of the equation is to seek care for LBP early vs. late. Many studies show seeking treatment within the first 3o days tends to result in better overall functional outcomes with reduced cost (1-4,6). This means you should not wait for 3 wks before seeking any form of care from MD or PT. Many MDs will just say you will be fine (which really may be the case) and come back in another 4-6 wks if still having issues. Well, by that time, patients now have dealt with LBP for 7-9 wks.  This means they are working themselves closer to that chronic state, which then takes more time to recover from.

The good new is, PT can greatly help reduce pain and improve ones physical function.

AND the better news is many insurances allow patients to come directly to physical therapy without having to see your MD first. Sooner treatment means on average a quicker return to function AND…..wait for it…..you will save your wallet more money.  How? By needing fewer PT visits, fewer MD visits, and hopefully no injections or imaging for general back pain (9).

Now I know there are those of you saying, well there must be something seriously wrong with my back and imaging can help determine what IT is. False!!! Most individuals over the age of 40 yrs have abnormal findings on imaging (7) and most do not correlate with functional limitations. Yes, there are some cases where imaging is necessary, but those are the exceptions not the rules, and can negatively influence patients on a psychological level (8).

Bottom line, many individuals will recover from back pain within a matter of days or weeks…HOWEVER, if it does not, then the best option is to call your physical therapist who can help guide you back to better health AND teach you how to prevent recurrences.

Want more information on preventing and managing back pain?  Then check out my new E-book entitled “7 Simple Tips for Managing and Self-Treating Low Back Pain.” Why suffer with back pain any longer? All you have to do is click the link to receive your Free copy today.

References:

1 Childs et al. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Services Research (2015) 15:150 DOI 10.1186/s12913-015-0830-3

2 Fritz et al. Initial Management Decisions After a New Consultation for Low Back Pain: Implications of the Usage of Physical Therapy for Subsequent Health Care Costs and Utilization. Archives of Physical Medicine and Rehabilitation 2013. http://dx.doi.org/10.1016/j.apmr.2013.01.008

3 Fritz et al.Primary Care Referral of Patients With Low Back Pain to Physical Therapy. Impact on Future Health Care Utilization and Costs. Spine 2012;37:2114–2121

4 Fritz et al. Does Adherence to the Guideline Recommendation for Active Treatments Improve the Quality of Care for Patients With Acute Low Back Pain Delivered by Physical Therapists? Med Care 2007;45: 973–980

5 Jarvik et al. Association of Early Imaging for Back Pain With Clinical Outcomes in Older Adults.  JAMA. 2015;313(11):1143-1153. doi:10.1001/jama.2015.1871

6 Wand et al. Early Intervention for the Management of Acute Low Back Pain. A Single-Blind Randomized Controlled Trial of Biopsychosocial Education, Manual Therapy, and Exercise. Spine 2004;29:2350–2356

7 Boden et al. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J. Bone Joint Surg. Am. 72:403-408, 1990

8 Flynn et al. Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder That Unnecessary Imaging May Do as Much Harm as Good.  J Orthop Sports Phys Ther 2011;41(11):838-846, Epub 3 June 2011. doi:10.2519/jospt.2011.3618

9 Fritz et al. Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges. Health Research and Educational Trust DOI: 10.1111/1475-6773.12301