IT MAY NOT SOUND SEXY BUT THE FACT IS THAT PHYSICAL THERAPY IS THE ANSWER TO BACK PAIN

PROVIDENCE, RI (8/7/13)

Back pain drives people to seek relief from their doctor. In fact 1 in 10 of all primary care visits is for low back pain1. Treatment of back pain has become costly and frequently includes overuse of treatments unsupported by clinical guidelines.

“Over the last 10 years we have seen patients with back pain managed in ways that are expensive, ineffective and most importantly actually harmful to the patient. This has included prescriptions for narcotics, recommendations for bed rest, expensive diagnostic imaging and recommendations for alternative forms of treatment that have never been proven to be effective”, states Michelle Collie PT, DPT, MS, OCS, of Performance Physical Therapy.  

From 1997 to 2005 there was an estimated 65% increase in expenditure for health care for people with spine problems with no improvement in health status, disability, work limitations or social functioning2.  A 2012 study provided evidence that early physical therapy is associated with decreased risk of advanced imaging, additional physician visits, surgery, injections and opioid medications, leading to a savings of $2,736.23 per patient3.

“Conservative, early and active treatment of back pain emphasizing movement and education has proven to provide the best outcomes, satisfied patients with the lowest costs,” states Dave Pavao DPT, OCS, Clinic Director, Performance Physical Therapy.

In a recent study published in JAMA Internal Medicine, researchers at Beth Israel Deaconess Medical Center in Boston looked at records of 23,918 doctor visits for simple back pain between 1999 and 2010. They found that doctors are not following clinical guidelines and are increasingly prescribing expensive scans, narcotics and other treatments.

Why is this? “People continue to look for a quick fix when it comes to pain. It takes a lot of time to educate a person on why a conservative and active treatment approach such as physical therapy is actually the best treatment for a complaint such as back pain. People want the expensive MRI, despite the fact this will not change the actual treatment. People want to try treatment that offers fast relief, no matter the price, no matter the risk and often, no matter the actual evidence”, states Collie.

Improving the management of spine-related pain and diseasewill result in cost savings and improvement in quality of care. Following clinical guidelines is a simple and sensibleway to minimize the overspending that continues in our health care system and improve patient satisfaction and outcomes. Payers, patients and health care providers all need to respect and follow the clinical guidelines, which is the best evidence available for providing the best care.

Sources:

1. Mafi, JN et al.,Worsening Trends in the Management and Treatment of Back Pain. JAMA Internal Medicine. July 2013.http://archinte.jamanetwork.com/article.aspx?articleid=1722522
2. Martin et al. Expenditures and health care status among adults with back and neck problems. JAMA 2008;13.
3. Fritz et al. Primary care referral of patients with low back pain to physical therapy, SPINE 2012; 37:2114-2121.

Similar Articles:

USA today; Back Pain Treatment

NPR: Doctors increasingly ignore evidence in treating back pain

New York Times:Back pain remains overtreated

Editor’s Note: Michelle Collie is available for additional comments. mcollie@performanceptri.com

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