For the past week, the pain and stiffness in your lower back has been unbearable. Daily activities like unloading the dishwasher, opening the car door, and taking the trash out are a struggle. Even sneezing is painful. You missed a day of work and your spouse has taken over all childcare duties. If you can relate to this scenario, then you probably think an MRI will give you the answers you’re looking for, right?
Actually, that’s not the case according to the American Academy of Family Physicians. Imaging of the lower spine within the first six weeks doesn’t improve outcomes, but it does increase costs. A study that appeared in the scientific journal Health Services Research concluded that physical therapy costs far less than advanced imaging.
The study, led by researchers Julie M. Fritz, PT, PhD, FAPTA, Gerard P. Brennan, PT, PhD,
and Stephen J. Hunter, PT, PhD, OCS, focused on 841 individuals who consulted with a primary care provider about uncomplicated low back pain. Of those individuals, 385 were referred to advanced imaging, 377 were referred to physical therapy, and 79 received a physician specialist visit or other care, including chiropractic.
The average cost differences between the study groups were staggering. An average of 3.8 physical therapy cost about $504 while magnetic resonance imaging rang in at about $1,306. During the subsequent year, costs were 66% lower for the patients who began with a physical therapy referral. Patients in physical therapy spent about $1,871 on their care, whereas the individuals in the imaging cohort spent $6,664.
Physical therapy is not only the least expensive first step in the treatment of low back pain, but also the most effective. Following an evaluation, a physical therapist takes an active approach to low back pain which often gives the patient the skills needed to self-manage their condition. The physical therapist’s goals include decreasing pain, increasing function and teaching strategies to prevent future back problems.
Physical therapy helps patients get to the heart of what’s causing the back pain and gives them tools to succeed in the future. Patients who are referred to imaging first are more likely [than the physical therapy cohort] to pursue other options including surgery, injections, specialist consultations, and emergency department visits within a year.
"Last Sunday I played full court basketball for the first time in 15 years. I will qualify the contest by saying it happened on a court just out of the back door of an elder care center. The teams consisted of a 7 year old, an d8 year old, a young woman in flip-flops (I played in sandals), a woman who proudly stated she was 55 years old (I retorted with my age of 65), and a couple of other young guys that really played well. I ran the court, I played defense, blocked shots, made shots (missed a lot), got lots of rebounds, and talked a lot of smack while playing with a group of people a lot younger than me. I even made a behind the back-twisting fall-away shot, then fell and tumbled on the court. I jumped up and continued to play, and we played for about 45 minutes.
I attribute my ability to play this game that I love so much again to the excellent training receive from Kristy who is a trainer at A2 Physical Therapy. I have worked out and trained since I was very young. I played high school basketball, baseball, and I ran track. I spent 20 years in the Army with all the training requirements associated with that occupation. I played on community and city leagues, and I have trained with weights for many years. The training program Kristy has devised for me at A2 is rigorous, thorough, diverse, fun, challenging, and focused. She prepares workout plans that are age and fitness level appropriate. My work out now is so much different then it was when I first started. She both trains me individually and as a couple. I run, jump, stretch, lift, balance, squat, push, pull, and every other movement you can imagine. I look forward to going to my workout every time. Kristy is completely in charge of every workout. I am retired, and my training at A2 allows me to fill the need to accomplish something positive every day I work out. I am doing physical activity with ease that I would not have thought I would be able be able to accomplish at the age of 65 such as hiking on Mt Rainer and running 4 days per week. Kristy and A2 have really changed my life…"
"My experience was great. Pain in my lower right quadrant of my back is virtually gone. This has improved my quality of life tremendously. Everyone I had contact with was very courteous and helpful. Special thanks to Alika and Danny for helping me learn exercises that have helped my back. Thank you."
"I loved it here! Everyone was so kind and welcoming and it is a very comfortable space to be in. That made it 100X easier to work on things, and ask plenty of questions. I seriously can’t think of anything to improve upon! Everything worked and helped me feel better, and is so exciting! Because of this, I can do more, and spend less time hurting."