- Your Bridge to Health -

Getting physical activity significantly reduces the risk of arthritis
September 21, 2017

The specific benefits of different amounts of physical activity are not completely clear

It should be commonly known by now that being physically active on a regular basis is beneficial and has a protective effect against many diseases and health conditions. Despite this, it’s not completely clear how this protective effect differs based on the exact amount of physical activity an individual gets. In other words, what amount of physical activity is necessary to experience specific effects, and how does this change with greater amounts of activity? The World Health Organization (WHO) currently recommends getting 600 metabolic equivalents (MET) minutes of total activity each week in order to obtain health benefits. A MET is a unit of measurement used to describe the amount of energy exerted when performing physical tasks or activities, and 600 MET minutes in a week is approximately equal to walking (4 METs) for 150 minutes or running (8 METs) for 75 minutes total. Totals for MET-minutes are calculated by multiplying the METS for the activity by the number of minutes it’s performed, so five hours of gardening (4 METs) in a week equates to 4 x 300 = 1,200 MET minutes. Though these values are commonly used for physical activity recommendations, it’s not completely understood to what degree they reduce the risk for certain health conditions and if greater amounts reduce this risk even more. Therefore, a powerful pair of studies called a systematic review and meta-analysis was conducted. The systematic review gathered all of the highest-quality evidence on the topic available, and the meta-analysis compared the findings of these studies to one another to establish a conclusion.

Researchers identify 174 studies for the systematic review and meta-analysis

Researchers searched through two databases for studies that examined the connection between physical activity and the risk of any of the following five health conditions: breast cancer, colon cancer, diabetes, heart disease and stroke. In particular, they were interested in the total MET-minutes per week of individuals and how that affected their risk for any of those five conditions. After screening 6,965 studies, researchers identified 174 that fit the necessary criteria and were used for the meta-analysis.

Risk for disease is lowered with more physical activity, but only to a certain point

Results from the meta-analysis showed that higher levels of total physical activity were associated with a lower risk for all five of the health conditions that were looked into. The health benefits that individuals experienced were found to be the greatest once achieving a certain amount of physical activity, but after that point, the decrease in risk for the conditions studied was minimal. One of the main examples to illustrate this point is the following: individuals who got 600 MET-minutes per week of physical activity had a 2% lower risk of diabetes compared with those who did not get any physical activity. When the amount of physical activity increased from 600 to 3,600 MET minutes/week, this risk was reduced by an additional 19%. After this, however, similar increases in physical activity only led to small reductions in the risk for diabetes. Similar trends were found with the other health conditions examined as well.

Individuals should get more physical activity than what is recommended

Based on this, researchers said that getting 3,000-4,000 MET-minutes per week appears to be the ideal range for obtaining the most health benefits and the greatest reduction of risk for the five health conditions. More physical activity than this may not necessarily lead to more benefits or a lower risk. The researchers, therefore, suggest that the physical activity levels of individuals should be significantly higher than what is currently recommended (600 MET-minutes/week) in order experience the greatest reduction in risks for breast cancer, colon cancer, diabetes, heart disease and stroke. Since it may take some time before any recommendations are actually changed, individuals can take matters into their own hands and work towards getting more physical activity for their overall health and risk for a disease.

-As reported in the August ’16 issue of The BMJ

Exercise and physical therapy help patients with knee arthritis
September 15, 2017

Unclear if additional sessions make therapy any more effective

Osteoarthritis (OA) is a common disorder in which cartilage that normally surrounds and protects joints wears away gradually over time. Overweight or obese individuals and those over the age of 65 are also more likely to develop it. There are many treatments available for knee OA, including exercise that may be combined with manual therapy. In this type of therapy, a physical therapist performs manipulations and mobilizations with their hands to reduce pain and improve function. Unfortunately, it’s not clear if the use of manual therapy adds any extra benefits to exercise alone. Some patients may also struggle to retain their improvements in the long term. One suggestion is to include “booster sessions,” in which patients meet with their physical therapist regularly for weeks or months after their initial sessions to discuss their progress and help them with recommendations to keep improving. Once again, research is lacking on whether these booster sessions are actually beneficial for patients. For this reason, a powerful study called a randomized-controlled trial (RCT) was conducted to compare the effects of manual therapy, booster sessions and exercise therapy for patients with knee OA.

Large sample of patients randomly divided into four even groups

Individuals with knee OA were recruited to participate in the RCT and screened to determine if they fit the necessary criteria. A total of 300 patients were accepted for the study and randomly assigned to one of the following four groups: 1) exercise with no booster sessions, 2) exercise with booster sessions, 3) manual therapy with exercise (no booster sessions), and 4) manual therapy with exercise and booster sessions. The exercise program, which all four groups performed, consisted of various strengthening, stretching, agility and balance exercises. In some cases, additional exercises were added for the hip and ankle if patients seemed to need them. For manual therapy, different maneuvers were applied with manual force from the therapist to increase the flexibility of the knee and surrounding muscles. This all took place during 12 sessions, with those who didn’t receive boosters doing all of them in nine weeks, and those with boosters spreading them out more evenly over 11 months. All patients also followed a home-exercise program twice a week or more that included the same exercises that were performed during the program. Participants were evaluated for pain, function and other measures before treatment, and then nine weeks and one year later.

All patients improve, but role of booster sessions and manual therapy not clear

After nine weeks, patients in all four treatment groups experienced significant improvements in all the outcomes measured. By one year, some of these effects had reduced, but for the most part, the improvements lasted. Despite this, the addition of booster sessions or manual therapy was not found to result in any greater benefits for patients after one year. Some positive effects were noticed, but they did not remain in the long term. Based on these findings, it appears that exercise is clearly effective for reducing pain and improving the function of patients with knee OA. Although booster sessions and manual therapy may help patients improve even more, it was not found to be the case in this study. Additional research is needed to investigate the role of booster sessions in more detail, but for now, patients with knee OA should feel confident that a physical therapist can effectively treat their condition with various exercises and help them achieve improvements that last in the long term.

-As reported in the August ’16 issue of Osteoarthritis and Cartilage

Adding movement to stretching is more beneficial
September 7, 2017

No studies have evaluated the combination of these two types of treatment before

Adhesive capsulitis, or frozen shoulder, is a condition that causes stiffness and pain in the shoulder joint. It restricts the function and motion of the shoulder, which makes it difficult to perform many activities normally. Frozen shoulder is most common in adults between the ages of 40-65 and those who have had the condition in the past, and its cause is still not well understood. Treating frozen shoulder is a long and difficult process, and there are several different strategies that may be used. One of them is called joint mobilization, in which a physical therapist moves the shoulder in different directions to increase its flexibility and reduce pain. Another is manual stretching exercises, which are stretches that are also performed by a physical therapist for the same purpose. Although these techniques have been supported by medical literature as to be effective, combining the two of them has not yet been studied. Therefore, a study called a randomized-controlled trial (RCT) was conducted on the topic. RCTs are the most powerful type of individual studies available, and they compare two groups of patients that are randomly assigned to different treatments.

Two small groups of patients undergo treatments for six weeks

Individuals with frozen shoulder were recruited to participate in the RCT and evaluated to determine if they fit the necessary criteria. Of the 42 patients that were screened, 26 fit the criteria and were then randomly assigned to either the joint mobilization and stretching group or the stretching exercise alone group. Treatment took place during three sessions each week for six weeks, with patients in the combination group receiving both treatments, while the others only received stretching exercises. The joint mobilization exercises were applied by the physical therapist at a lower rate at first, and their intensity increased further into the treatment sessions. This was dependent on the tolerance and pain of each patient. The therapist completed stretching exercises while the patient lay on the bed in 20-minute sessions of 20 seconds of stretching followed by 10 seconds of rest. In addition, patients in both groups followed a home-exercise program twice a day for the duration of treatment. These consisted of 10 repetitions of stretching and strengthening exercises, and patients were told to continue these for at least one year after treatment. All patients were assessed for pain, disability, and flexibility before treatment, immediately afterward, and then one year later.

Combining both treatments is more effective than stretching exercises alone

Results showed that the patients who received the combination of joint mobilization and stretching exercises experienced better outcomes than those who only had stretching exercises. This was seen in measurements for flexibility, pain, shoulder function and the ability to perform daily activities, and the improvements were present up to one year later. These findings suggest that the addition of joint mobilizations to manual stretching exercises leads to the best possible outcomes for patients with frozen shoulder. All physical therapists are capable of performing both of these techniques, and patients with frozen shoulder are therefore encouraged to seek out their services when deciding what type of doctor to visit for treatment.

-As reported in the August ’16 issue of Clinical Rehabilitation

Hands-on physical therapy are effective for a shoulder condition
August 30, 2017

Condition lasts at least one year and consists of three phases

Adhesive capsulitis, commonly called frozen shoulder, is a condition that causes pain, stiffness, and loss of motion in the shoulder. It occurs in about 2-5% of the population and is most common in people between the ages of 40-60. Frozen shoulder lasts approximately 12-42 months, and consists of three phases. It starts with a painful phase lasting 2-9 months, which is followed by a stiff phase for 3-12 months in which the shoulder becomes very stiff and difficult to move. The last of these is the healing, or thawing phase, in which patients regain their movement and function over the course of 5-26 months. Physical therapy is commonly used to treat frozen shoulder, and one of the techniques used by physical therapists is called mobilization. This consists of various hands-on movements applied to the shoulder to increase its flexibility and reduce pain. Although mobilizations are frequently used, it’s not clear how effective they are and which techniques are best. For this reason, a powerful type of study called a systematic review was conducted. The review collected all available literature on the topic to determine which mobilization technique was most effective for frozen shoulder.

A total of 12 studies are accepted for the review

Researchers performed a search using two medical databases for any studies that looked into different mobilization techniques to treat frozen shoulder. A total of 12 studies with data on 810 patients fit the necessary criteria and were included in the systematic review. Seven different types of mobilization techniques were evaluated, and the main patient outcomes measured were pain and range of motion, which is a measure of how much they could move their shoulder. The data from all of these studies was evaluated in depth, and their quality was also assessed to determine how reliable their findings were.

A combination of a few types of techniques is most effective for frozen shoulder

On the whole, mobilization techniques were found to be beneficial for patients with frozen shoulder. A combination of one approach called the Maitland technique with the mobilization of the spine and shoulder stretching appears to be best for reducing pain and improving shoulder flexibility. For this reason, this combination of techniques is recommended for patients with frozen shoulder; however, there was not enough information on many of the other mobilization techniques in the review. Therefore, additional research is needed to investigate these other techniques in more detail so it can be more clearly determined which is the best for treating frozen shoulder. While this process takes place, patients with frozen shoulder should acknowledge that mobilization techniques performed by physical therapists are generally helpful for reducing pain and increasing the flexibility of their shoulder.

-As reported in the August ’16 issue of the Archives of Physical Medicine and Rehabilitation

Treatment program with neck exercises leads to more satisfaction
August 16, 2017

Many patients with whiplash injuries go on to have long-term complications

Whiplash is an injury that occurs after the neck experiences a forceful movement that jerks it back and forth. They tend to cause pain and stiffness that can last for a while. In addition, about half of all patients that have a whiplash injury go on to develop symptoms and complications that can persist for more than one year. These are called whiplash-associated disorders (WADs), which often lead to poor mental health and decreased satisfaction with life. Although WADs are common, there is no clear evidence as to which treatment is best for them. Both general physical activity and exercises designed specifically for the neck are often prescribed, and it’s possible that neck-specific exercises are more effective. Sometimes, these neck-specific exercises are also accompanied by a behavioral approach that targets patients’ mental state in the process.

New study conducted to evaluate long-term outcomes of earlier research

A study was conducted to compare these treatments, and it found that neck-specific exercises were generally more effective than a general physical activity for WADs; however, it did not analyze the satisfaction level of patients. Therefore, another study was performed to evaluate these outcomes in the long-term and determine if different types of treatment led to greater overall satisfaction in patients.

Three groups of patients are evaluated for one year

Patients with long-term WADs were recruited to participate, and a total of 216 fit the necessary criteria and were accepted to the study. These patients were then randomly divided into three groups: the neck-specific exercise group, the neck-specific with behavioral approach group or the prescribed physical activity group. In the neck-specific exercise group, patients were prescribed an exercise program that focused on the neck. During these sessions, which took place twice a week, patients performed various exercises that targeted muscles deep in the neck. Patients also followed a home-exercise program, and more intense treatment was prescribed later on. Patients in the second group followed the same treatment as the first group. The only difference was the program progressed more slowly and was accompanied by education and instructions from a physical therapist on how to manage their pain. In the physical activity group, a physical therapist instructed patients to get involved in a regular physical activity of their choice on a regular basis, and no exercises for the neck were prescribed. All treatments lasted for three weeks, and patients were told to continue exercising afterward. In this analysis, patients were assessed for treatment satisfaction and other variables for up to one year.

Greater improvements lead to greater overall satisfaction

Results showed that after one year, the satisfaction of all patients with their treatment improved over time, regardless of the type of treatment they received. However, the patients who received neck-specific exercises were found to improve significantly more over time than those who received physical activity. They also reported greater enablement and expectation fulfillment, which are related to satisfaction. This was apparent regardless of whether behavioral therapy was also used. Considering the fact that the earlier study also showed patients who received neck-specific exercises experienced less pain and greater functioning, it appears that these improvements were associated with better satisfaction levels as ell. Patients with WADs can benefit from seeing a physical therapist for a treatment program that focuses heavily on neck-specific exercises in order to experience the best possible outcomes and highest level of satisfaction with their treatment.

-As reported in the August ’16 issue of the Journal of Orthopaedic and Sports Physical Therapy

Physical therapy improves health and is effective for its cost
August 11, 2017

New strategies are needed to address rising health care costs

Health care costs are continuing to rise in many developed countries throughout the world, which is partially due to a growing number of people approaching retirement age. In the U.S., millions of individuals still don’t have health care insurance, and many of those who do are not satisfied with their plan. This highlights the need for new strategies to address rising health care costs and make effective insurance more affordable for individuals. One concept that plays a major role in this process is cost-effectiveness, which essentially determines how much someone is getting out of a treatment based on how much it costs. A treatment that is highly cost-effective will produce good results without costing too much. Physical therapy is one treatment that’s considered by many in the field to be cost-effective since it usually leads to notable improvements and is reasonably priced. To develop a clearer understanding physical therapy’s cost-effectiveness, a powerful study called a systematic review was conducted. This systematic review collected all the available evidence on the cost-effectiveness of physical therapy compared to usual care, which includes appointments with doctors, medications and other services. Its goal was to determine just how cost-effective physical therapy is for patients to better guide treatment decision-making.

18 studies fit the necessary criteria for review

Researchers performed a search of four major medical databases for relevant studies on the cost-effectiveness of physical therapy compared to usual care for various conditions. After screening 367 initial matches and going through additional references, they found 18 studies that fit all the necessary criteria and were used for the review. The findings of these 18 studies were evaluated and compared to one another, and the quality of each study was also assessed to determine the reliability of the information they provided.

Physical therapy leads to improved health and is generally found to be cost-effective

Results from this systematic review showed that physical therapy, either on its own or added to usual care, led to improved health. This was found to be the case in almost all studies included. Regarding cost-effectiveness, six out of eight studies found that physical therapy on its own was cost-effective when compared to usual care. In addition, four out of 11 studies found physical therapy to be cost-effective when combined with usual care. Overall, this amounted to more than half of the studies supporting the cost-effectiveness of physical therapy. One reason this figure is not higher is the fact that different definitions of cost-effectiveness were used in the included studies. This may have made it difficult to determine the true cost-effectiveness of physical therapy. Nonetheless, this review shows that physical therapy is beneficial for leading to improvements in health, and it is generally cost-effective for patients. Additional studies should look into this matter in greater detail and researchers should also work towards establishing a clearer definition for cost-effectiveness, which will make comparing studies easier in the future.

-As reported in the June ’16 issue of Physical Therapy

Surgery is not found to be more effective for treating injuries
August 2, 2017

Many patients who have surgery go on to experience long-term complications

The rotator cuff is a network of tendons and muscles in the shoulder that keep it stable and allow it to move in a variety of directions. Due to its frequent use, the rotator cuff is also a region that is frequently injured, especially in certain athletes and older adults. It’s estimated that at least 10% of the population over the age of 60 experiences tears of the rotator cuff, which can seriously limit a patient’s ability to function normally. Treating rotator cuff tears is normally done either with surgery or with a non-surgical (conservative) approach. Physical therapy is commonly used as one of the major conservative treatments for these injuries. Although there is no clear evidence to support either of these approaches as being more effective than the other, the rates for surgery to treat rotator cuff tears has increased substantially in recent times. In addition, it’s been reported that within 1-3 years after surgery, between 20-90% of patients remain unhealed or go on to tear their rotator cuff again. Based on this, it appears that more information is needed to show whether surgery or conservative treatment is more effective for these injuries. Therefore, a powerful study called a meta-analysis was conducted, which analyzed all available research on the topic to determine which of these treatments should be used.

Six medical databases are searched for relevant studies

To conduct the meta-analysis, researchers looked through six major medical databases for studies that compared surgery to conservative treatment for rotator cuff tears. All studies that appeared relevant were assessed in detail to decide if they fit the necessary criteria. Out of the 319 studies that were identified, only three fit these criteria and were accepted for the analysis. All three were randomized-controlled trials (RCTs), which are considered the highest-quality type of individual study that can be performed. These three RCTs included data on 252 patients in total, and they were analyzed and compared to the one another with the goal of reaching a conclusion on the best possible treatment.

No important differences found between two treatments

Results showed that after one year, no significant differences were found between patients who had surgery compared to those who had conservative treatment. This was determined based on scores for two separate measurements used for overall pain and function, as patients reported similar scores regardless of which treatment they had. The findings of this meta-analysis suggest that surgery is no more effective than conservative treatment for rotator cuff tears. Due to the fact that only three studies were included in this analysis and the overall sample group of patients was small, additional studies are now needed to investigate this matter further. Before these studies are completed, a conservative treatment that includes physical therapy should be regarded as the best possible option for rotator cuff tears. This is based on the findings of this analysis and the fact that surgery is more expensive and associated with more complications than conservative treatment.

-As reported in the July ’16 issue of Disability and Rehabilitation

Using desks with a standing capability may increase work productivity
July 28, 2017

Sitting for too much of the day associated with negative health effects

Most Americans spend a great deal of their time each day&#8211approximately 8-9 hours&#8211sitting. This is primarily due to the fact that the majority of employed individuals work desk jobs that require a seated position. This type of lifestyle, in which a person sits for large portions of the day, is called sedentary behavior. Numerous studies have shown that sedentary behavior is associated with several negative effects on health, including obesity, heart disease, diabetes, and cancer. This may even be true for individuals who are physically active and meet the recommended guidelines. One particular group of workers who are affected by sedentary behavior is call center operators, who spend about 90-95% of their work shift in their seats. As a result of the recognized dangers of sitting, the use of standing desks has been introduced to some offices. Standing desks have been received well and have been found to reduce discomfort and improve work efficiency. For this reason, a new study was conducted to determine the effects of stand-capable workstations on work productivity in a call-center over six months. A stand-capable workstation means that the height of the desks could be adjusted.

Two groups of workers are compared over six months

A total of 167 employees in a call center who provided health and clinical advising over the phone served as the study group. These employees were split into two groups: one group of 74 workers would use stand-capable desks, while the other 93 were to use standard seated desks. The stand-capable desks used were either sit-to-stand or stand-biased. Sit-to-stand desks could switch from a sitting mode to a standing mode, while the stand-biased desks could be adjusted to different heights, and when low enough, the user could sit at them on a high stool. These two groups then used their desks for six months, and data on their work productivity was collected from them on a daily basis.

Workers with stand-capable desks sit less and are more productive

Results showed that workers using the stand-capable desks were more productive than those who were using the standard seated desks. On average, the stand-capable workers had 0.5 more successful calls per hour than seated workers over the entire span of the study, especially the final five months. The productivity of the stand-capable workers increased from about 23% in the first month to 53% over the next six months, and these workers were found to be about 45% more productive overall than seated workers. Although it’s not entirely clear why the stand-capable desks led to an increase in worker productivity, it’s possible that it may be due to less body discomfort, better functioning or a combination of these factors. Other studies have identified these positive effects of stand-capable desks, and additional studies will help to better understand it. On the whole, this current study shows that using a stand-capable desk can increase the productivity of workers by getting them to sit for less of the day. Future research should continue to look into this matter further while other efforts push to introduce these types of desks in more workplaces.

-As reported in the May ’16 issue of Physical Therapy

Physical therapists may be an alternative to seeing a doctor first
July 20, 2017

Aging population will increase the number of patients doctors have to see

A large percentage of the population throughout the world is getting older. In the United Kingdom, the current percentage of the population over the age of 65 is 17%. This has grown from 15% in 1985 and is predicted to rise to 23% by 2035. Similar changes are also occurring here in the U.S. As a result of this increase in the elderly population, there will also be an increase in the number of health conditions that are related to old age. In particular, arthritis and painful conditions that affect the back, shoulders, and knees (musculoskeletal conditions) are all expected to rise. As it stands, most of these patients with musculoskeletal conditions go to see their general practitioner for treatment or a referral to another doctor. But as the population continues to age, it will become difficult–if not impossible–for general practitioners to handle the amount of patients seeking treatment.

Why physical therapy may be part of the solution

For this reason, something needs to be done to ease the load of patients seen by general practitioners. One possible solution is to have patients see a physical therapist for any musculoskeletal conditions first, instead of their general practitioner. Physical therapists typically see patients with these conditions and are well-equipped to diagnose them, treat them and/or refer patients elsewhere. Although some research has been conducted on this topic, additional evidence is needed to support this type of approach to treatment. Therefore, a study was conducted to evaluate if having patients see a physical therapist first for musculoskeletal conditions was safe and effective and if patients were satisfied with the treatment they received.

Patients from two physical therapy practices are evaluated

Two experienced physical therapists were placed at two general medical practices–one in the inner city and one at a university–to provide care for patients. When patients called to make an appointment for issues related to a musculoskeletal condition, they were given the option of seeing the physical therapist as an alternative to the general practitioner. Patients who went with this option were given one or two 20-minute appointments with the physical therapist, which was meant to be as similar to an appointment with a general practitioner as possible. During these appointments, patients were screened for other conditions and offered advice on how to deal with their pain, mainly with exercise and lifestyle changes. If it was determined that a patient needed ongoing physical therapy care, he or she was referred to the full-time physical therapist at their second appointment. All patients were given a questionnaire and assessed for measures like pain and function at their first appointment, and then again one and six months later.

Physical therapy first is safe, effective and less expensive

Results from this study showed that seeing a physical therapist instead of a general practitioner for a musculoskeletal condition was safe, as no patients experienced any negative effects from the treatment. It was also effective, as the majority of patients were found to improve their condition at one and six months later. In addition, 70% of patients who saw a physical therapist first reported that they were completely satisfied with the treatment they received. Finally, the physical therapy-first approach was found to be significantly less expensive than seeing a general practitioner first. Together, these findings show that visiting physical therapists for musculoskeletal conditions is both safe and effective, and less expensive than general practitioners. Considering the fact that up to 30% of complaints a general practitioner sees are related to musculoskeletal conditions, this shows that physical therapy may very well serve as an alternative for patients. More research is needed to investigate this matter in greater detail and confirm these findings, but this study provides hope for both general practitioners and patients alike to address the aging population issue. Patients may, therefore, consider making an appointment with a physical therapist rather than their general practitioner the next time they experience a musculoskeletal condition.

-As reported in the June ’16 issue of Physical Therapy

Patients who see physical therapists spend less time and money
July 14, 2017

Physical therapists are one of the main providers of care for low back pain patients

It’s estimated that about 84% of the population will experience at least one episode of low back pain at some point in their lifetime. Although most cases of low back pain will improve completely within 2-4 weeks, approximately 25% of individuals will go on to have continual episodes of pain and long-term problems. There are several different types of medical professionals that are involved in treating low back pain, but physical therapists are one of the main providers of treatment. When it comes to treating these patients, there is a current set of clinical practice guidelines that have been developed by experts based on the best available research. Though all physical therapists are supposed to be following these guidelines in order to provide the best possible treatment, recent statistics say that only about 30% are actually doing so. Whether or not physical therapists follow these guidelines may have an effect on how much treatment patients have, and how much they spend as a result. Considering the fact that no study has investigated this topic yet, a powerful study called a systematic review was conducted to determine what sort of impact these guidelines have on how patients utilize their healthcare.

Four studies fit the necessary criteria

Researchers searched through four major medical databases for studies on the use of physical therapy for low back pain. They only accepted higher-quality studies that recorded how much patients spent on their treatment and how much care they received overall. This search led to a total of four studies that fit the necessary criteria and were used in this systematic review. The findings of each study were analyzed and compared to one another, and the quality of all studies was also evaluated.

Patients use less overall healthcare when guidelines are followed

The findings of these four studies showed that when physical therapists gave treatment that was in line with current guidelines, patients had less healthcare and spent less overall on their care than those who did not. This was found to be the case due to fewer physical therapy visits, shorter duration of treatment sessions, fewer prescription medications, fewer visits to the doctor and less use of injections and advanced imaging like MRIs. Overall, this saved patients between $300 and $1,300 on the care they received for low back pain. Out of a maximum score of 26 for quality, all studies scored between 19-21, which shows that these findings were based on high-quality studies.

There are a number of reasons some physical therapists do not adhere to current guidelines when treating patients with low back pain, but one point seems clear: those that do save their patients money and time. Patients with low back pain should, therefore, check to see if a physical therapist follows the current clinical practice guidelines for low back pain before making any treatment decisions.

-As reported in the June ’16 issue of Physical Therapy