Physical Therapy Has A Small Beneficial Effect In New Onset Back Pain

MedicalResearch.com Interview with:
Julie M. Fritz, PT, PhD, FAPTA

Professor, Department of Physical Therapy
Associate Dean for Research, College of Health
University of Utah
Salt Lake City, UT  84106

Medical Research: What is the background for this study? What are the main findings?

Dr. Fritz: Low back pain affects up to 80% of adults at some point in their lives and back pain is among the most common reasons why someone visits their primary care provider.  Despite how common back pain is, the health care system does a surprisingly poor job of managing patients with the condition. There are many things that can happen at the initial primary care visit for back pain that are unhelpful or may even delay recovery such as ordering an MRI or prescribing opioids. Most practice guidelines recommend that primary care providers avoid ordering an MRI or opioid pain medication, reassure the patient that they will begin to feel better quickly and then wait a few weeks before considering referral to physical therapy.  Others have suggested that earlier use of physical therapy may be more beneficial to patients.  We conducted this study to compare early physical therapy with a wait-and-see approach.

Medical Research: What should clinicians and patients take away from your report?

Dr. Fritz: The patients who received physical therapy did better, but not a great deal better.  Patients receiving early physical therapy had less disability, greater satisfaction and higher quality of life scores 4 weeks and 3 months after beginning the project, but the differences with the wait-and-see group were small.  The results suggest that patients and clinicians may want to consider physical therapy as an option early in the course of a back pain episode if they want or need a little assistance with recovery.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Fritz: More research is needed to try to determine which patients might particularly benefit from early physical therapy.  This may be a more beneficial option as compared with waiting for those individuals who are anxious or fearful that they might not recover.

Citation:

Fritz JM, Magel JS, McFadden M, et al. Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial. JAMA.2015;314(14):1459-1467. doi:10.1001/jama.2015.11648.

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Julie M. Fritz, PT, PhD (2015). Physical Therapy Has A Small Beneficial Effect In New Onset Back Pain