Early physical therapy for low back pain associated with less health care utilization

Although rates vary by state, published results showed that early initiation of physical therapy for acute low back pain was associated with reduced healthcare utilization over 30 days and 1 year in the United States.

Using the Truven MarketScan database, researchers identified 979,223 patients (mean age 47 years) who presented with acute low back pain (LBP) between 2010 and 2014. They compared health care utilization and expenditure among his 110,834 patients who underwent initial physical therapy (PT). 868,389 patients who did not receive early PT. Early PT was defined by at least one session within 2 weeks of initial presentation of LBP. PT prescriptions and spending rates were assessed by US states.

Researchers found that patients who received PT early had lower healthcare utilization rates at 30 days and 1 year. Early PT on day 30 was associated with lower odds of chiropractor visits (odds ratio). [OR] = 0.41), pain specialist visit (OR = 0.49), ED visit (OR = 0.51), advanced imaging (OR = 0.57), orthopedic visit (OR = 0.67), and epidural steroid injection ( ESI) (OR = 0.68). Additionally, the average LBP-related expenditure for patients who received early PT was $1,180, whereas the average LBP-related expenditure for patients who did not receive early PT was $1,250 over 30 days. However, at 1 year, his average LBP-related expenditure for patients who received early PT was $2,588, whereas his average LBP-related expenditure for patients who did not receive early PT was $2,510.

“These findings examine downstream healthcare costs and utilization by reducing the use of advanced imaging, specialist visits, ED visits, and ESI 30 days and 1 year after injury in patients undergoing early PT. In practice, it has important implications for guiding health policy,” the researchers wrote in their study. “Furthermore, early PT was associated with lower his LBP-related spending during his first 30 days from initial presentation, whereas his 1-year spending after the index visit was higher. I did,” they added.