The evidence continues to build on the benefits of early Physical Therapy for patients with low back pain. Previous researchers have found successful outcomes and decreased health care costs (up to $1500 per episode of care) when patients are treated with early vs. delayed Physical Therapy or compared to usual care including primary care, education, and pain medications. Due to its’ clinical and cost benefits the U.S. military, fortune 500 companies, and many states including Colorado allow Physical Therapists to practice as a first line provider for patients with musculoskeletal pain. A recent study in the Annals of Internal Medicine describes this treatment approach for patients with sciatica.
Fritz and colleagues from the University of Utah published recently published their randomized controlled trial on the outcomes associated with early Physical Therapy (Ann Int Med. 2020). Authors randomized 220 adults with sciatica (leg pain referred from the spine) of less than 90 days duration to either early Physical Therapy or usual care after an initial examination by a physician. Patients in the Physical Therapy group received 4 weeks of Physical Therapy including manual therapy and exercise. Authors reported greater improvements in disability in the short and long term among those receiving early Physical Therapy. These significant differences in pain and recovery continued up to 1 year after randomization. In addition, these patients reported greater levels of treatment success compared to their peers receiving usual care.
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