New lower back pain (LBP) patients who received a physical therapy referral within 14 days of diagnosis had a decreased likelihood of interventions including spinal injection and lumbar spine surgery and 60% lower total LBP-related costs.

According to a study of Military Health System (MHS) lower back pain (LBP) patients published in the journal BMC Health Services Research, initial management decisions following a new episode of LBP have significant implications for patient outcomes and downstream utilization and costs.

Patients who received early physical therapy were less likely to receive advanced imaging, spinal injections, or lumbar spine surgery, and had lower utilization of opioids. During a 2-year follow-up period, total LBP-related costs for patients receiving early physical therapy were an average of $1202.29 lower compared to patients receiving delayed physical therapy. Similarly, non-LBP healthcare costs were an average of $1011.22 lower for early physical therapy patients than those who received delayed physical therapy.

The authors suggest that cost savings from early guideline adherent physical therapy could have important implications when optimizing care process models in single payer systems. Further research is needed to examine which patients with LBP benefit from early physical therapy, to devise strategies for delivering early guideline adherent care and to define causal relationships before policies can be revisited.

Childs, J. D., Fritz, J. M., Wu, S. S., Flynn, T. W., Wainner, R. S., Robertson, E. K., … & George, S. Z. (2015). Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC health services research, 15(1), 1.