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Back pain? Call your physical therapist first.

So you’ve hurt your back.  You lifted something the wrong way, bent down to pick up the newspaper and felt a twinge, stepped off a curb, or even got into a car accident. Where can you get help for that nagging pain in your back?

At some point in your life there is a 70-80% chance that you will experience some type back pain.   Each year, Americans spend more than $50 billion dollars on treatments related to back pain, alone.   There are so many options and so many opinions about what you should do for treatment, but what works? 

Physical therapy is the best option. This is because physical therapists know how to diagnose not just spinal injuries, but also musculoskeletal disorders that contribute to your dysfunction. The right therapist can treat your symptoms, and also teach you how to avoid injury in the future. I tell my patients to find someone who can also recommend a course of self-treatment that gives them freedom from repeated episodes and visits. And I’m always here for them if they need advice or help, or additional complex therapy in the future.

It’s important not to wait!  In most states and the District of Columbia, you can call your physical therapist directly. In almost every state, no referral is necessary to see a physical therapist.

Traditional referral medicine delays care. This goes against the way we traditionally think of medicine: our first line of defense when we don’t feel quite right is our primary care practitioner, who frequently refers to a specialist, who may then refer to physical therapy, possibly only after ordering multiple tests.  This cascade of referrals that results in going to a physical therapist to manage the pain anyway only results in increasing the time from injury to actual hands-on treatment and relief. The referral system is actually a product of antiquated managed health care insurance, not patient treatment. Under the old system, patients would see a primary care physician or speicalist first. But evidence shows that not seeing a physical therapist first is likely to cause you more pain and cost your more money.

Recent studies prove that early Physical Therapy is better than referral to Specialist care. A growing number studies have demonstrated the benefits of early physical therapy.  Dr. Gary Brooks, Professor of Physical Therapy at SUNY Upstate Medical University, recently published studied outcomes for over 65,000 patients. In some cases the patients saw a physical therapist early on, and in other instance the patients followed the traditional, and long path to therapy. The results clearly demonstrate that patients who saw a physical therapist quickly had better outcomes, as compared to referrals from other specialists. Similar research from Julie Fritz and colleagues at the University of Utah also demonstrated that faster access to care resulted in a need for fewer physical therapy visits and a decreased risk of needing more back pain related healthcare in the future.

Why does early physical therapy treatment make such a difference?  Physical therapists are able to use evaluation skills to determine which manual techniques will be beneficial, which muscles need to be strengthened, which muscles need to be lengthened, and which movements need to be re-learned in a more correct manner.  Essentially our assessments lead to actual personalized treatment, as compared to continued tests and referrals.

I see all my patients for an hour, and have been known to spend closer to an hour and a half attempting to find and address the source of a patient’s problem.  More direct, individualized contact with patients allows us more bang for our – or more correctly, your – buck.