People with acute lower back pain who got physical therapy early after the onset of symptoms spent less money on related health care costs 30 days and one year later.
The health care resources people avoided using include advanced imaging, specialty appointments, epidural steroid injections, and emergency room visits.
Patients who began physical therapy early were half as likely to visit the ER within 30 days of symptom onset than those who did not receive early PT, which the study defined as starting within two weeks of symptom onset.
Lower back pain affects a sizable portion of the US population, ranging from 1.4% to 20%, and accounts for substantial health care expenditures.
“Our goal was to determine if early PT for patients with lower back pain had an impact on their overall health care resource utilization,” says Richard Skolasky Jr., director of the Johns Hopkins Spine Outcomes Research Center, and lead author of the study published in BMC Health Services Research.
“We were especially curious about the 30 days after initial symptom onset, as this is when patients are most likely to seek care.”
Using Truven MarketScan, a group of US-based administrative health care insurance claims databases, the researchers selected nearly 980,000 US claims cases. The de-identified patients in these claims had an average age of 47 and initially presented with acute lower back pain from 2010 through 2014. Approximately 11% of the patients received early PT.
From the cases reviewed, the team assessed the use of health care resources and the cost of the lower back pain-related services that were coded with a musculoskeletal system diagnosis. The team then compared these results at 30 days and at one year after presentation between patients who received early PT and those who did not.
Compared with those who did not receive early PT, the early PT group had a significantly lower incidence of using health care resources, such as ER visits, in the first month and the first year after presenting with acute lower back pain. The early PT group also spent less money on lower back pain-related services in the first 30 days after symptom onset.
“As the US population ages, the prevalence of lower back pain is expected to increase, along with the associated costs of treating it,” says Skolasky. “Furthermore, with advances in imaging and treatments, the cost of managing lower back pain has increased substantially. Our findings have important implications that may guide health care policy when examining downstream health care costs and resource utilization.”
The researchers believe that future research on the effects of early PT should incorporate measures of clinical outcomes to determine its impact on patient health.
Source: Johns Hopkins University