Low Back Pain: Do I really need to go to a Physical Therapist (PT) right after seeing my Primary Care Physician (PCP)?

Low back pain (LBP) is one of the leading health care complaints throughout the United States, and treatment for LBP is among the top of health care costs. The World Health Organization conducted a worldwide study in 2010, which looked at prevalent diseases by region. This study, the “Global Burden of Disease Study,” included low back pain. Some results are noted below:

  • among the top 10 diseases and injuries that account for the number of Disability-adjusted life years (DALY) worldwide

[a DALY is  a measure of disease burden as the number of years lost due to decreased health, disability, or death]

  • lifetime prevalence of nonspecific LBP is estimated at 60-70% in industrialized countries [each year, affects 15-45% of adults depending on region]
  • prevalence of LBP rises between ages of 35-45
  • LBP is the leading cause of activity limitation and work absence throughout most of the world

Because LBP has such a high rate of occurrence, it is logical that it also accounts for such a high percentage of all primary care physician cases. The question then becomes, how do patients relieve themselves of such pain? Julie Fritz, John Childs, and Timothy Flynn attempted to answer this question in a 2012 study published in “Spine.” The authors looked at a national database of over 32,000 patients, and compared the patients who attended physical therapy within 90 days of the first PCP consultation. They further stratified patients into early intervention (physical therapy within the first 14 days after consultation) and late intervention (PT did not begin within 14 days). Between the early- and late-intervention groups, the study looked at overall cost of healthcare related to LBP for 18 months following the initial PCP consultation, and overall utilization of healthcare in the same timeframe.

The results of this study revealed that patients who began physical therapy within 14 days of the initial PCP consultation had a reduced risk of requiring further healthcare. The authors note that further research is needed to determine which LBP patients will reach similar benefits from physical therapy, but when recommended, those who begin a therapeutic regimen are less likely to consume additional healthcare costs in those 18 months following entrance to the healthcare system.

For more information on WHO’s 2010 Global Burden Disease Study: http://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf

Fritz, Childs, and Flynn 2012 “Spine” Study: http://rugnetwerktwente.nl/wp-content/uploads/2015/10/LBP.PrimaryCare.Fritz_.Spine_.2012.pdf