Managed Physical Medicine

The Future of Low Back Pain Treatment: Innovative Care Models

Can these three progressive care models bring us closer to standardized treatment for LBP patients?

This blog is part 3 of a three-part series titled “How We Treat Low Back Pain: Emerging Research, Frameworks and Care Models.”

Despite technological advances in a range of specialties, healthcare in America – rehabilitative medicine included – can still feel quite fragmented. Three patients exhibiting the same symptoms of low back pain (LBP) may see a family doctor and be prescribed an anti-inflammatory, go to a chiropractor for manipulation three times a week, visit a PT and begin doing rehabilitative exercises – or all of the above. So, how do we get from today’s inconsistent care pathways to a unified model of LBP treatment?

When used together, these three progressive care models may bring us closer to standardized care for LBP patients.

1. Managed Care

Navigating today’s healthcare system can often be a confusing experience for patients. Although there are organizational recommendations guiding care practices, each practitioner comes to the table with a unique approach and their own opinions on what first-line care should be. As it currently stands, many patients are left to advocate for themselves and coordinate their own care among specialists.

Specialty managed care organizations like MedRisk look to bridge this gap by coordinating care through evidence-based care guidelines. In today’s volume-based healthcare system, physicians, PTs and chiropractors are not always set up or incentivized to read from the same playbook – especially when it comes to workers’ compensation. An evidence-based care model with a return-to-work focus encourages a more unified approach. Patients are evaluated for level of injury, severity and risk and then progress through the appropriate pathway of treatment and rehabilitation. This results in a clearer direction for providers, a streamlined experience for patients and a more direct path to quality care.

2. Telemedicine

A big part of effective care is keeping patients actively involved in the management of their own condition. Keeping patients engaged on their road to recovery and facilitating the performance of at-home exercises can be critical to successful return to work. Many providers, payers and managed care organizations achieve these goals through the use of telerehabilitation, whereby health assessments and consultations are delivered through a virtual platform in lieu of an in-person visit. Research has shown clinical outcomes to be similar between telemedicine services and in-person clinical services. Not all treatment plans translate well to telerehabilitation, such as those for patients who require special exercise equipment or who have unusual or heavy work demands. However, in some instances, in-clinic PT sessions can be supplemented with valuable remote offerings including online education and virtual home exercise supervision to create a hybrid treatment plan. Telerehabilitation is a low-cost method for providing targeted education, individualized consultation and increased clinician facetime to support positive patient outcomes.

3. Direct Access

When you consider the number of providers who can initiate treatment for a musculoskeletal injury, it is easy to see how treatment plans can vary among those with similar injuries. However, there is an emerging field of professionals who aim to change all that.

Practitioners who hold the Primary Spine Practitioner certification (like the one offered by the University of Pittsburgh) specialize in the frontline diagnosis, management and triage of spine-related disorders such as LBP. In a 2011 article by a group led by Donald Murphy, DC, FRCC, a well-known expert on spinal care and a member of the MedRisk advisory board, primary spine care providers are compared to general dentists, whose domain is understood to be the oral health of our society. According to Murphy, the primary spine care practitioner’s role is to “apply evidence-based procedures, appropriately educate and motivate patients and effectively prevent and manage disability related to [spine related disorders].” Only time will tell whether primary spine practitioners will become a new direct access point for LBP patients. But if they do, according to Murphy et al, we can look forward to improved outcomes of care, increased patient satisfaction, and reduced costs (i.e., high-value care).

Want to help standardize care for your injured workers? Learn more about MedRisk’s managed physical medicine services.