For Back Pain, Physical Therapy Plays Key Role in Prevention and Rehabilitation

The piece was originally published in Hampton Roads Physician Summer 2017  

By Brian Hoy, PT, CMP, FMS-C

The goal for any physical therapist is straightforward: To help our patients gain or regain the highest degree of quality of life possible.

Meeting this goal involves both prevention and rehabilitation. And while our human body is both fragile and resilient, one area that is frequently a source of discomfort is the back. In addition to discomfort and frustration, back pain also brings high financial cost and is a significant cause for missed work.

A University of North Carolina study found that “that more than 80 percent of Americans will experience an episode of low back pain at some time in their lives and that total costs of the condition are estimated at greater than $100 billion annually, with two-thirds of that due to decreased wages and productivity.”

Further, according to the American Physical Therapy Association (APTA):

  • “61% of Americans experience low back pain.”
  • In a survey, “69% of respondents indicated that low back pain affects their daily lives.” Most affected: Exercise, sleep, and work.
  • “Three out of four women take over-the-counter or prescription medication” to treat the symptoms.
  • 31% of men and 20% of women report that “low back pain affects their ability to work.”

So what role can physical therapy play in helping address this global epidemic?

The first is cost effectiveness. The APTA states, “Early physical therapy can be cost-effective treatment for low back pain.” Indeed, the APTA notes, “a recent study suggests there’s no reason to delay physical therapy that might relieve the pain.”

Another benefit of physical therapy in treating back pain is the avoidance of medication and opioids.

A study published in JAMA Internal Medicine (“Worsening Trends in the Management and Treatment of Back Pain” indicates that “physicians often over-treat back pain, with increases in use of imaging, narcotics, and referrals to other physicians. The over-treatment leads to unnecessary expenses,” according to the APTA.

Of course, sometimes back and spine problems persist and a doctor may advise that surgery is required. Even these individuals, though, can benefit from physical therapy – before the surgery occurs.

As the APTA notes: A study published in the journal Spine (Preoperative pain neuroscience education for lumbar radiculopathy), “followed a group of individuals who were undergoing surgery of the lumbar spine.”

“Prior to surgery, half of the participants received the typical pre-surgical care.  The other half received specialized education from a physical therapist on the neuroscience of pain.  The researchers followed up with the participants 1 year after surgery and found the group who received a single, educational session from a physical therapist, viewed their surgical experience much more favorably, and utilized 45% less health care expenditure following surgery.”

Of course, physical therapy cannot solve all back pain issues. However, given the number of people this problem afflicts – and given the associated costs, missed work, and frustration – inquiring about the role PT can play in both prevention and rehabilitation can pay significant dividends.

Brian Hoy, PT, CMP, FMS-C serves as Vice President of Clinical Services and Director of the Clinical Excellence Team at Pivot Physical Therapy.