Low Back Pain, Think Physical Therapy

Low back pain is one of the leading causes of doctors’ visits and missed time from work. It’s estimated that 80% of the people in the United States will seek medical care for low back pain at some point in their lives, and there are likely more that have pain, but don’t seek treatment. So if you are having low back pain, you are certainly not alone. Unfortunately low back pain may not only hurt you physically, but seeking a diagnosis and treatment can hurt you financially as well.

Save Money with Physical Therapy

A recent study of 841 adults seeking medical care for low back pain showed that individuals who obtained an MRI to assist in diagnosing their condition are much more likely to request surgery or injections than their counterparts who were sent to physical therapy first. This led to an average of $4,793 more in medical expenses for those individuals who had the MRI vs those who did not. Patients who seek physical therapy first often see a relief in symptoms and outcomes comparable to their counterparts who obtained an MRI and other medical procedures. This begs the question, why do most patients with low back pain receive an MRI first instead of a physical therapy evaluation?

The Problem with MRI

While advanced diagnostic imaging techniques have their place, and certainly make diagnosing conditions easier, patients with low back pain may not be the best candidates. Most of us will show signs of degenerative disk disease or a herniated disk on MRI, whether or not we are experiencing pain or symptoms. This means that two people can have very similar MRI results, but one may be experiencing pain, while the other is not. The truth of the matter is typically, MRI results will not drastically change the course of physical therapy treatment. Physical therapists are skilled at identify what may be causing the pain, and fixing that problem, opposed to strictly treating a diagnosis. So if MRI results don’t typically change the course of treatment, why not skip that expensive step, and start physical therapy first. If a physical therapist can’t improve the patient’s condition, then the option to obtain an MRI and alternative treatments will be there later.

What does Physical Therapy do for Patients with Low Back Pain?

Physical therapy is more than just manual techniques and exercises. A physical therapist should spend a lot of time educating a patient on their condition. Helping a patient understand what may be causing the problem or causing exacerbations of pain are important to helping relieve or prevent symptoms. Most patients with low back pain often try bed rest to relieve symptoms because moving becomes too painful. Unfortunately we now know that bed rest and lack of movement can actually make a patient’s condition worse. A physical therapist can help educate a patient on ways to modify activities so they can participate in daily activities and return to work without increasing their symptoms. Small tips like placing a lumbar roll in your chair or getting up from your desk and taking a 5 minute walk around the office every hour can make a big difference.

About the author:

Dr. Kevin Prue PT, DPT, CSCS is a graduate of Duke University’s Doctor of Physical Therapy Program. He is the president and director of Prue Physical Therapy & Sports Performance (www.pruept.com) located in Cary NC. He specializes sports and orthopedic physical therapy, sports performance training and injury prevention for youth and recreational athletes.