Battling Back: Early Physical Therapy Intervention Improves Low Back Pain—and Reduces Costs

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By Brian Mason, PT, DPT

If you’re suffering from low back pain and are putting off clinical treatment, you may experi- ence more pain—and higher medical costs—in the future.

Approximately 80 percent of adults experience low back pain at some point in their lives, according to the National Institute of Neurological Disorders and Stroke. The condition is the most common cause of job-related disability and a leading cause of missed work days.

A recent research study found that patients who were referred to a physical therapist within two weeks of seeing their primary care physicians used fewer medical resources and paid lower health care costs than those who delayed treatment. Specifically, those who underwent physical therapy had a reduced risk of needing surgery, injections, additional physician vis- its, opioids, and advanced imaging studies. In fact, health care costs for patients receiving early care from a physical therapist were significantly lower, on average. In short, the data shows that the sooner a patient starts physical therapy, the faster they recover, which ulti- mately saves them money.

What Causes Low Back Pain?

If trauma, such as a car accident, isn’t the cause, low back pain most often develops due to mechanical stresses over a long period of time. This can be from sitting too much, improper lifting techniques, poor posture, poor strength conditioning and/or poor core strength.

The condition can occur at any age. While the average age of those needing spine surgery in the United States is age 40, more children are experiencing back pain than in previous generations because they are sitting more and moving less, and many are looking at devices for prolonged periods of time.

To determine the cause of pain, a practitioner will look at a patient’s medical history and perform a physical exam, and may order tests. I have found that if I listen to my patients, they will explain what they are experiencing in detail, enabling me to make a more accurate diagnosis.

When Should I Seek Treatment?

Patients need to start active recovery as soon as possible. This means that after a day or two of limiting your activity, you should take action to return to your previous level of function. If you haven’t returned to normal in two weeks, you should seek clinical intervention.

The first step is to find a practitioner like a physical therapist who understands active recovery, bed rest, and modalities such as traction, massage, elec- trical stimulation, manipulation, and pain medications. These are short-term treatments that can relive pain. In New Jersey, patients can access physical therapy services without a physician referral.

How Can Physical Therapy Help?

Severe low back pain is very painful, and more importantly, it can be scary for patients. Often, when I see patients in the emergency department, their fears about the condition are nearly as important to address as the physical pain and reduced mobility that they are experiencing. It’s important that I help each patient overcome their fear of physical activity to prevent it from impacting the rehabilitation process.

The goals of physical therapy are to: • Minimize distress

• Restore function quickly
• Encourage patients to be active participants in their recovery
• Educate patients about their specific injuries and how to avoid reinjury • Develop a recovery program that patients can continue after therapy

• Reduce the need for opioid pain medications, which rarely improve healing

For example, if I see a patient who has low back pain that’s so severe that they have trouble bending at the waist, I’ll develop a therapy program that’s designed to empower the patient to address underlying factors that contributed to the condition.

The most important thing to remember is that if you are experiencing low back pain, the sooner you take steps to recover, the quicker you can resume doing the things you love, and avoid more expensive, invasive treatment down the road.

Brian Mason, PT, DPT, is the clinical director of Rehabilitation Services at CentraState Medical Center. He can be reached by calling 866-CENTRA7.