Managed Physical Medicine

Does It Pay to Delay Physical Therapy? Study Says No

A new study shows that immediate referral to and initiation (within 3 days) of physical therapy may lead to reduced utilization and costs for acute LBP patients.

You’ve injured your back on the job, and you’re waiting on a call back for a referral to a PT. A day goes by, then three days, then a week. What does this mean for your future treatment?

Nearly 1 of 55 patients with low back pain (LBP) are referred for physical therapy by physicians; however, there is a lack of consensus regarding when that referral should happen.1 A study of Medicare beneficiaries with new-onset LBP found that of those who received PT, 52% received physical therapy within 4 weeks, 18% between 4 weeks and 3 months, and 30% after 3 months.2 Some researchers have expressed concern that patients could experience subsequent recurrences when intervention is delayed, leading to additional healthcare utilization and increased costs.

A 2018 study in Physical Therapy set out to determine whether timely PT intervention affected the treatment patterns of LBP patients in New York state over a one-year period. Examining commercial claims data, Liu et al found that referral and initiation of treatment with a physical therapist within 3 days may lead to less service utilization – and reduced LBP-related costs – down the road.3

The study’s participants, low back pain (LBP) patients, were divided into cohorts based on whether they received physical therapy and the timing of PT treatment. Researchers also analyzed the likelihood of service utilization and LBP-related health care costs over a 1-year period.

Results showed that following the group that did not receive physical therapy, patients with immediate physical therapy initiation (within 3 days) had the lowest utilization rates and cost measures, with some exceptions. Data supports MedRisk’s operating model, which prioritizes timely treatment for injured workers, ensuring that appointments are scheduled within 4 hours, with an average wait time of 2.6 days to first appointment.

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1 Mafi, J. N., McCarthy, E. P., Davis, R. B., & Landon, B. E. (2013). Worsening trends in the management and treatment of back pain. JAMA internal medicine173(17), 1573-1581.

2 Gellhorn, A. C., Chan, L., Martin, B., & Friedly, J. (2012). Management patterns in acute low back pain: the role of physical therapy. Spine37(9), 775.

3 Liu, X., Hanney, W. J., Masaracchio, M., Kolber, M. J., Zhao, M., Spaulding, A. C., & Gabriel, M. H. (2018). Immediate physical therapy initiation in patients with acute low back pain Is associated with a reduction in downstream health care utilization and costs. Physical therapy98(5), 336-347.