The authors report no relevant financial disclosures.
While rates varied from state to state, early initiation of physical therapy for acute low back pain was associated with less 30-day and 1-year health care utilization in the United States, according to published results.
Researchers used the Truven MarketScan database to identify 979,223 patients (mean age of 47 years) who presented with acute low back pain (LBP) between 2010 and 2014. They compared health care utilization and spending between 110,834 patients who received early physical therapy (PT) and 868,389 patients who did not receive early PT. Early PT was defined by at least one session within 2 weeks after the index visit for LBP. PT prescriptions and spending rates were assessed by U.S. state.
Researchers found patients who received early PT had lower health care utilization at 30 days and 1 year. At 30 days, early PT was associated with lower odds of chiropractor visits (odds ratio [OR] = 0.41), pain specialist visits (OR = 0.49), ED visits (OR = 0.51), advanced imaging (OR = 0.57), orthopedic visits (OR = 0.67) and epidural steroid injections (ESIs) (OR = 0.68). Additionally, patients who received early PT had a mean LBP-related spending of $1,180, while patients who did not receive early PT had a mean LBP-related spending of $1,250 at 30 days. However, at 1 year, patients who received early PT had a mean LBP-related spending of $2,588, while patients who did not receive early PT had a mean LBP-related spending of $2,510.
“These findings have important implications to guide health care policy when examining downstream health care costs and utilization with less use of advanced imaging, specialist visits, ED visits and ESIs during the 30 days and 1 year after injury for patients receiving early PT,” the researchers wrote in the study. “Furthermore, early PT was associated with less LBP-related spending during the first 30 days after initial presentation, but higher spending during the year after the index visit,” they added.