- Your Bridge to Health -

PTs are experts at identifying imbalances to prevent injuries
March 19, 2019

When most people hear about physical therapy, they usually tend to think that it’s only for disabled individuals and those who are recovering from injury. While it may be true that physical therapy is perhaps most commonly used on patients that fall into these two categories, this is far from its only application. Physical therapists can also help individuals reduce their risk for injury by identifying any imbalances that might be present and addressing them with a targeted exercise program.

Physical therapists are rehabilitation specialists and experts at evaluating how each patient moves their body when performing normal daily tasks. They then use this information to determine if the individual has any issues with their posture, strength, motion, or balance (which is usually the case, since very few people move “perfectly.”)

What many people don’t realize is that these issues generally exist prior to the onset of pain and increase the chances of an injury occurring. It’s for this reason that a great deal of pain related to bones and muscles, as well as many injuries, can actually be prevented. But injury prevention requires identifying potential problems and strategically addressing them, and physical therapists are the most qualified medical professionals to provide this service.

Whether you get lots of physical activity or not, you’ve probably dealt with your share of pain in one form or another. Painful conditions like low back pain, neck pain, and ankle soreness are extremely common across the board in both active and sedentary individuals, and it’s often difficult to pinpoint exactly what the source of pain is. While most of these episodes will improve over time on their own, that doesn’t necessarily mean that the pain won’t return or is nothing to be concerned with. In some cases, these apparently minor bouts of pain may actually be warning signs for a bigger problem with more pain or an injury down the road. It’s often challenging to know the difference, but this is exactly what physical therapists specialize in.

A physical therapy program can prevent injuries and other medical conditions in a number of different ways, but in all cases the approach is the same: help patients to move better and more frequently so that their bodies become more efficient and balanced. Below are some highlights of how physical therapy is used to prevent injuries and when it may be appropriate:

  • Education: after performing a thorough evaluation of your body and movements, your physical therapist will identify areas that are weak, out of balance, or inflexible; from here, the therapist will educate you by explaining these deficits and what can be done to address them in order to reduce your injury risk
  • Sport-specific injury prevention: for athletes involved in a single sport, your physical therapist can provide you with a training program that takes into account the movements involved and common injuries in order to reduce your risk
  • Lifestyle modifications and exercise recommendations: if you’re not exercising regularly or lead a sedentary lifestyle that involves lots of sitting, your physical therapist will recommend that you become more active in general and also offer specific ways to do so in your daily life; leading a physically active lifestyle is considered one of the best ways to reduce the risk for a host of health conditions like arthritis, diabetes, heart disease, and some types of cancer
  • Prehabilitation: surgery may be needed for patients with severe injuries, but the procedure is not the end of the story; a rehabilitation program before surgery—called prehabilitation—will help you prepare the body for what’s to come and drastically increase the chances of a successful recovery with a lower risk for injury in the future

This shows that physical therapy is not only for injuries that have already occurred, but also for stopping those from occurring in the first place. This can easily be achieved by seeing a physical therapist for a full-scale evaluation and then following their recommendations afterwards. Perhaps the best part is that you don’t need a referral from another doctor to see a physical therapist. All 50 states and Washington, D.C. allow for direct access, which means you can schedule a physical therapy appointment on your own whenever you’re ready.

If you have a painful condition, physical therapy is your best option
March 12, 2019

Have you dealt with any pain recently—or perhaps right now—that prevents you from moving or completing certain tasks normally? If so, it’s probably due to some type of musculoskeletal disorder. This term is used to describe a wide array of conditions that are frequently responsible for causing all sorts of disabilities, but there is one common thread between all of them: they can be effectively treated by physical therapy.

A musculoskeletal disorder is an injury or condition that involves the musculoskeletal system—which includes the bones, muscles, joints, ligaments and tendons. These disorders are extremely common, as about 30% of Americans are currently dealing with one at any point in time.

Musculoskeletal disorders can develop anywhere in the body, but there are certain conditions that occur much more frequently than others. Back pain, especially low back pain, is by far the most common of all musculoskeletal disorders. It is the leading cause of disability in the U.S. for those under the age of 45, and more than 26 million Americans between 20-64 experience frequent back pain. Severe headaches and neck pain rank just behind back pain and often lead to bothersome symptoms that interfere with daily life. Other common musculoskeletal disorders include osteoarthritis, tendinitis, and stress fractures, as well as a variety of issues related to other parts of the body. Below is a sample of some of these conditions in commonly injured joints:

  • Knee: runner’s knee, jumper’s knee, iliotibial band syndrome
  • Shoulder: frozen shoulder, rotator cuff tears, shoulder impingement
  • Wrist: sprains, carpal tunnel syndrome
  • Ankle/foot: ankle sprain, Achilles tendinitis, plantar fasciitis
  • Elbow: tennis elbow, golfer’s elbow

Individuals dealing with a musculoskeletal disorder have many options when it comes to deciding how to address it. Some will do nothing and hope that pain will go away on its own, while others may see their doctor, who might prescribe medications like opioids, additional tests, or in severe cases, surgery. Another option is physical therapy, which gets to the root of the problem and addresses it with a series of carefully designed exercises and treatments that are individually tailored to each patient. Treatment therefore varies from one patient to the next, but typically consists of the following:

  • Evaluation: required to determine the source of the pain and to identify which of musculoskeletal disorder is present
  • Strengthening exercises: essential for areas that have become weak
  • Stretching exercises: targets regions that have lost flexibility
  • Manual therapy: mobilizations and manipulations to the soft tissue of injured areas to reduce pain and improve function
  • Posture training: may be needed if posture is a factor
  • Lifestyle modifications: habits and other lifestyle choices that may be contributing to the injury are identified and suggestions are provided on how to modify them

So if a musculoskeletal disorder is holding you back from enjoying your life, it’s important to realize that you have a number of options, but physical therapy will nearly always be your best path forward to less pain and better functioning.

Understanding the truly massive scale of the opioid epidemic
March 5, 2019

The presence of pain—especially pain that lasts for a long period of time—is perhaps the most common reason that people seek out medical help. Because pain is such a unique and subjective experience, it’s also one of the most controversial and complex medical conditions to treat. There are a seemingly endless number of options available to treat pain, but none receive nearly as much attention these days as opioids, and there are a great many reasons why this is the case.

Opioids are powerful pain-relieving medications that have been used to treat pain as far back as 1775, but it wasn’t until the late ‘80s and early ‘90s that “the opioid epidemic” really started to pick up. Around this time, it was believed that opioids could be used safely and effectively to treat chronic (long-lasting) pain, and a push was made to more aggressively manage painful conditions with these drugs. This misguided belief led to opioids being overprescribed on a massive scale, and a number of other factors have contributed to widespread overuse, addiction, and overdoses throughout the country.

Every day, about 130 Americans die from an opioid-related overdose. In 2017, there were over 70,000 drug overdose deaths, with approximately 68% of these involving opioids. And the startling statistics don’t end there. To put matters in better perspective, here are some additional figures on opioid prescription and abuse in the U.S.:

  • Although the U.S. represents less than 5% of the world’s population, we consume more than 80% of the global supply of opioids
  • In 2016, healthcare providers wrote more than 214 million prescriptions for opioids to manage pain, which equates to about 66.5 prescriptions for every 100 Americans
  • As many as 1 in 5 people receive an opioid prescription for non-cancer pain
  • The number of opioid prescriptions increased by 600% from 1997-2007
  • Between 1999-2017, there were more than 700,000 drug overdose deaths, with about 400,000 of these being related to opioids
  • In 2017, the number of overdose deaths involving opioids was six times higher than it was in 1999

So as you can see, far too many individuals are prescribed opioids for their pain every year, and a great deal of them—over 11 million in 2016—go on to abuse these drugs. While opioids do serve an important and necessary role in managing some types of pain, one of the primary issues is that they are frequently being prescribed for many patients with conditions that would benefit more from other interventions. This is because opioids are only meant to decrease each individual’s perception or sensation of pain, and they are not intended to actually address the factor responsible for the pain. In this way, opioids only “mask” the pain and don’t do anything to alleviate it, which is why they are only supposed to be used temporarily until the pain subsides.

Pain is an extremely tricky problem to treat. There is no single solution that will eliminate pain in all individuals, and what works for some won’t work for others. Opioids are often prescribed to solve a complicated issue with a simple fix, but as the numbers very clearly show, the risks associated with these drugs far outweigh the potential benefits. As a result, opioids should be avoided in most cases in favor of one of the many—safer—alternatives available to managing pain.

Some physical therapists may offer education on improving nutrition
March 1, 2019

What you consume can play a major role in your recovery process

When you visit a physical therapist for an injury, you typically expect to be provided with a program that includes various exercises, techniques and other treatments intended to reduce your pain and improve your physical abilities. What you may not expect is advice on nutrition and your diet, since physical therapy seems to be more focused on how the body moves. Focusing on patients’ physical condition is certainly a big part of physical therapy, and it’s for this very reason that some physical therapists are starting to offer nutritional education on top of their regular treatment as a useful tool to improve patients’ overall health outcomes. Since what you put into your body will affect how it works and how well it moves, these therapists are realizing that proper nutrition should be considered an essential component of any treatment program.

Five conditions associated with pain that better nutrition can help address

Learning about nutrition and making changes your diet can result in a bounty of benefits that will improve your health in a number of ways. But there are several conditions associated with pain that can directly benefit from a better diet, including these five:

  1. Inflammation: many foods that are popular in the Western diet—like vegetable oils and fried foods—increase inflammation and can often make injuries worse; a Mediterranean diet, on the other hand, which is rich in healthy fatty acids, fruits, vegetables, and fiber, fights inflammation and can be beneficial for individuals with rheumatoid arthritis and other inflammatory conditions
  2. Obesity: being obese contributes to many other chronic pain conditions, and the pain can, in turn, lead to less physical activity and make the problem worse; this is why weight loss through proper nutritional health should become a crucial part of overall pain rehabilitation
  3. Osteoarthritis: patients who are overweight or obese have an increased risk for developing osteoarthritis, especially in the knees and hips; it’s also been suggested that deficiencies of certain nutrients—including vitamins C and D, and selenium—contribute to osteoarthritis; this shows that focusing on nutrition may address osteoarthritis in several ways
  4. Autoimmune disease: approximately 23.5 million Americans have an autoimmune disease, and new research is suggesting that dietary changes over the past 50 years may have played a part in increasing rates of these diseases. Moving away from a high-sugar, high-salt and heavily processed diet to a more nutritious one may, therefore, reduce the occurrence of autoimmune disease.
  5. Prediabetes and type 2 diabetes: High pain levels in patients with type 2 diabetes can negatively impact their quality of life, physical function, and physical activity abilities. Diet is an integral part of managing diabetes, and improving it can yield a host of benefits.

How your physical therapist may be able to help

If you’re dealing with any of the conditions listed above along with an injury, your physical therapist may be able to offer some professional advice and education on the role your diet may be playing. By asking you about some of your dietary habits, suggesting that you keep a food diary, and establishing some simple and attainable goals, they can start you on a path to better nutrition and better overall health, which will, in turn, result in a faster recovery from your injury. Following a course that focuses on proper nutrition will also set you up for a better functioning body and a reduced risk for injury in the future.

-Summarized from a Nov. ’16 article published by theAPTA

Therapy can reduce pain and improves function for lower back pain
February 28, 2019

Many treatments available for extremely common condition

Approximately 80% of the population will experience low back pain (LBP) at some point in their lifetime, and it’s one of the most common reasons that leads patients to visit a medical professional for treatment. There are many treatments available for addressing acute LBP, which is pain that has lasted for less than six weeks, including pain medications, muscle relaxants, exercises and physical therapy. One intervention that physical therapists may utilize for LBP is called spinal manipulation, in which they manipulate certain parts of the spine with their hands in order to bring about changes that will reduce patients’ pain levels. Although some studies have found spinal manipulation to be beneficial for patients with LBP, others have found mixed results and called into question its actual effectiveness. For this reason, a powerful pairing of studies called a systematic review and meta-analysis was conducted to determine the true value of spinal manipulation for LBP.

26 studies are included in the comprehensive review

To conduct the study, investigators searched through four major medical databases for studies that evaluated spinal manipulation for LBP. They identified 40 articles and then screened them for inclusion, and from these, 26 randomized-controlled trials (RCTs) were accepted for the review. RCTs are high-quality studies in which groups of patients are randomly assigned to different treatment groups, and they are considered the gold standard for evaluating if an intervention is effective. Once accepted, all 26 RCTs were analyzed and their findings were compared to one another. In the final step, each study was assessed for its level of quality in order to help determine how reliable its findings were.

Spinal manipulation leads to significant benefits for six weeks

Results showed that spinal manipulation led to significant benefits for patients with acute LBP that lasted for at least six weeks. In particular, the treatment was found to be associated with reduced pain and improved function, and these improvements were graded as modest. In addition, spinal manipulation was only associated with very minor and temporary harms afterward. Twelve of the included studies were classified as high quality, while the other 14 were graded as low quality. This review adds to the literature that already exists on the topic, and should further strengthen recommendations to use spinal manipulation for patients dealing with acute LBP. Based on these findings, taking this type of approach will bring about several benefits in the short term. For this reason, additional studies are also needed to evaluate the long-term effects of spinal manipulation for patients with acute LBP.

-As reported in the April ’17 issue of JAMA

Immediately going to a PT for back pain found to reduce costs
February 26, 2019

Research lacking on the potential benefits of immediate physical therapy

Low back pain (LBP) is one of the most common and costly conditions in the world. It ranks as the leading cause of disability, and in 2014, approximately 68.6 million Americans—or 28.6% of the population—reported having LBP for a whole day or more in the prior three months. Physical therapy is supported by research as an effective treatment for LBP, and approximately 20% of patients are referred to a physical therapist by their doctor. Although it is generally agreed that these patients should remain active when LBP strikes, there is no consensus on when the best time is for them to begin physical therapy. While some guidelines recommend delaying physical therapy for several weeks, other studies have shown that this approach can cause patients to use more healthcare services and spend more in the process. There is also not a great deal of research on the potential benefits of immediate physical therapy in which patients see a physical therapist within three days of first experiencing LBP. With this in mind, researchers decided to conduct a study to examine healthcare usage and costs when patients receive physical therapy at various points in time.

Large health insurance claims database used

To conduct the study, investigators searched through a large health insurance claims database to identify patients with LBP. After excluding patients for various reasons, this search led to 46,914 fitting the necessary criteria and being accepted into the study. Based on their data, these patients were then divided into five groups depending on whether they received physical therapy and when therapy started: 1) no physical therapy, 2) immediate physical therapy (receiving physical therapy within three days of seeing their doctor), 3) early physical therapy (between 4-14 days), 4) delayed physical therapy (between 15-28 days), 5) late physical therapy (between 29-90 days). With these groups in place, researchers then compared healthcare usage and costs between them to determine if there were any advantages of seeing a physical therapist early.

Immediate physical therapy is associated with lowest costs and healthcare use

Of the 46,914 patients included in the study, 6,668 (14.2%) received physical therapy within 90 days. Of these patients, 2,052 (30.8%) started immediately, 2,219 (33.3%) did so early, 1,044 (15.7%) were delayed, and 1,353 (20.3%) were placed in the “late physical therapy” group. Comparisons between the patients that received physical therapy showed that those who did so immediately reported the lowest healthcare usage and costs in nearly all outcomes measured. In particular, it was found that these “immediate physical therapy” patients had the lowest opioid and pain medication use, emergency department visits, fewest advanced imaging tests (like MRIs), and lowest non-LBP-related costs. The results also showed that both costs and healthcare usage gradually increased as patients waited longer to begin physical therapy. Based on these findings, it appears that seeing a physical therapist for LBP immediately or early—within 14 days—will lead to the lowest costs and usage of various healthcare services, since physical therapists usually only recommend additional testing or procedures if they are completely necessary. Patients who are currently dealing with LBP are therefore encouraged to see a physical therapist as soon as possible in order to get started on a direct path to recovery without any detours.

-As reported in the May ’18 issue of Physical Therapy

Try several remedies for back pain and discover which work for you
February 19, 2019

For many individuals in our fast-paced society, every day is often seen as an opportunity to “get things done” in the most efficient and productive manner possible. But, there is a world of possible obstacles that can derail your daily plans, a painful condition like back pain can often be your biggest challenge.

Back pain is generally considered to be the most common condition that causes disability in the world. The back muscles and spine support much of the body’s weight, and we use these muscles in a significant number of our everyday movements like sitting, standing, and walking. So it’s not hard to see that when back pain arises, it can truly interfere with an individual’s productivity and ability to perform their best at work, and in daily life.

As a result, the response to this interference is usually the same for most people: how can I get rid of this pain quickly so I can return to functioning normally? Unfortunately, there is an abundance of options, but no single cure—or cures—that will work for everyone. What completely eliminated your friend’s back pain may not do a thing for you, and vice versa. This is why the smartest approach you can take is a process of trial and error, giving many different remedies a shot and seeing which ones lead to improvements. In most cases, it won’t be just one change, but rather a combination of several that are right for you. Below are some of the most effective home remedies that are worth trying.

Home remedies that can help alleviate your back pain

  • Ice/heat therapy: ice and heat are two of the most commonly recommended remedies for pain relief, and the reason is that they often work; try both for 20-30-minute intervals every few hours
    • Ice therapy reduces inflammation, which is often a culprit in any type of back pain, and it acts as a local anesthetic by slowing down nerve impulses; icing is best within the first 2-3 days after pain arises
    • Heat therapy stimulates blood flow, which brings healing nutrients to the painful areas of the back, and it inhibits pain messages being sent to the brain; use heat about 3 days after the pain starts, and try several methods like a hot compress, heating pad, or hot shower
  • Sleep: both how you sleep and how much you sleep can each have a big impact on your back pain, so it’s best to address both of them head-on
    • Change your sleeping position: sleeping flat on your stomach or back should generally be avoided, while some of the better positions for individuals with back pain are on your side with a pillow between your knees or in the fetal position, on your stomach with a pillow under your abdomen, or on your back with a pillow under your knees
    • Get more sleep: about 2/3 of people with chronic (long-lasting) back pain also suffer from some type of sleep disorder, and bad sleep can make back problems worse, so try to get the recommended 7-8 hours every night
  • Exercise: while it may seem logical to avoid movement when you have back pain, lack of physical activity can actually make your pain worse
    • General exercise: try to get at least 150 minutes of moderate-intensity exercise (like brisk walking) or 75 minutes of vigorous-intensity exercise (like jogging) every week
    • Core strengthening exercises: core strength can have a big influence on back pain, and these muscles are often not worked on in a normal day, which is why they should be specifically focused on; try these ab exercises
    • Hamstring stretches: if the hamstring muscles in the front of the thigh are too tight, the lower back and hip joints can get more stressed, which leads to more back pain; try stretching them out with these exercises
    • Additional strengthening exercises for the lower back
  • Other: some patients also find back pain relief through a variety of other home remedies and lifestyle changes
    • Posture training
    • Improving your workstation
    • Yoga, Tai chi, and meditation
    • Epsom salt baths

Also remember that many of the same tactics to prevent back pain also apply to treating it, so if you’re interested in learning more ways to ease your back pain, read our last newsletter that covers some smart back pain prevention strategies. Click here for our article on the “Best ways to reduce your chances of developing back pain.”

Best ways to reduce your chances of developing back pain
February 12, 2019

The fact that back pain is so common in the general population might make you feel as if you’re powerless to do anything to stop it from occurring. This can prove to be one of the biggest mistakes you can make, as failing to take any action whatsoever is certain to only make matters worse.

The truth is that your chances for developing back pain depend on a multitude of factors. Some of these factors, like your genetics, bone alignment, and age-related changes that eventually occur in everyone, are more or less completely out of your control. However, there are a great deal of other factors related to your everyday life and habits that also play a significant part in determining your chances of getting back pain. These are the factors that are ripe for change.

Weight problems, for example, are a big contributor to back pain. Not being a healthy body weight can put excessive pressure and strain on the spine, which weakens structures and increases the potential to experience pain. Obese individuals are especially more likely to suffer from low back pain because of their extra weight in the midsection, which pulls the pelvis forward and strains the lower back even more. Reduced fitness levels can also contribute to back issues, as having muscles that are weak or inflexible means there is less support for the spine and it can, therefore, become damaged more easily.

Key lifestyle changes to reduce your risk for experiencing back pain

If you’re concerned about your chances of confronting back pain at some point in your life, the best strategy you can devise is to make smart modifications now to your lifestyle. While there are no guarantees that any lifestyle changes will completely eliminate your risk, following these tips is sure to have a significant impact on reducing it:

  • Become more physically active: if you’re not already getting the recommended 150 minutes of moderate-intensity activity (like brisk walking) or 75 minutes of vigorous-intensity activity (like jogging) each week, you should make it a primary goal to reach these weekly targets; try various types of exercise to figure out which are best for you, and create a feasible exercise plan that you can stick with in the long term
  • Maintain a healthy weight: as mentioned above, weight is one of the bigger factors in determining risk for back pain, so losing weight should be another major focus if you are currently overweight; this is obviously easier said than done, so it may be best to see a dietician or nutritionist to identify dietary issues and establish a healthy eating plan
  • Stop smoking: smoking restricts blood flow to the intervertebral discs that lie in between the spinal bones (vertebrae), which gives smokers a much higher chance of having back pain; so quitting now is another great way to reduce your risk
  • Minimize excessive stress on the spine: the way you position your body when you’re sitting, standing, and walking all affect your spine, and excessive stress on the spine, over time, can cause back pain; so if you work at a computer, make sure it’s at eye level, sit with your feet flat on the floor and the back of your chair in an upright position; the keyboard should also be directly in front of you, close by, and at a height so your shoulders are relaxed, elbows slightly bent, and wrist and hands straight
  • Reduce stress levels: stress can cause you to tense and tighten your muscles, which deprives them of the energy needed to support the spine and can result in back pain; any activity that alleviates stress can therefore also affect back pain risk
  • Avoid high heels, extremely tight pants, and heavy handbags and briefcases: these lesser-known factors may also contribute to the development of back pain in various ways, so you should try to take steps to avoid them as much as possible

If you need additional motivation, you should notice that perhaps the best part of these lifestyle changes is that they don’t only apply to back pain risk. These are healthy behaviors in general that will lead to a number of other benefits in your life, so you can improve your health while also lowering your risk of experiencing back pain.

Back pain can strike in different ways at all stages of life
February 5, 2019

There are very few guarantees in life but chances are you’ll experience back pain at some point in your lifetime, as about 8 out of 10 people will deal with it at least once. The type of back pain you may experience will depend on your age, habits, and health, and it’s important to realize that some cases can be avoided while others are completely out of your control.

The spine consists of 33 bones called vertebrae, which are stacked on top of one another and interlocked to form the spinal column. The vertebrae are connected by small joints that allow the spine to move in various directions, and in between each vertebra is a structure called an intervertebral disc. These discs are filled with a jelly-like substance and their purpose it to absorb shock and prevent these bones from rubbing against each other. Together, these features allow you to rotate and turn your torso, and they help to make the spine one of the sturdiest structures in the body. But as with every other body part, there are many different things that can go wrong within the back, and the result is often pain.

The amount of control you have over your back pain decreases with older age

Between sports, playing with friends, and due to their seemingly never-ending source of energy, most kids lead a pretty active lifestyle. As a result of the constant activity, their bodies can take quite a beating, which are very resilient but still have a breaking point. When pushed too far, the result can be back pain, which is more common in children and adolescents than you might think.

Most of these cases are due to strains and sprains of the muscles and ligaments of the back, which can occur either from a single injury or over time after continuing to abuse the back. In particular, children that participate in various sports year-round without enough time to recover may have a higher risk for injuries like back pain. There’s also been an increase in adolescent back pain related to being overweight, as the extra weight puts stress on the immature spine and throws off posture, which causes the lower back to work harder to stay upright.

While these types of problems are possible throughout life, in young adults, back pain is more commonly associated with other types of resting behaviors. Many individuals in this age group spend a great deal of time on screens such as laptops, tablets, and smartphones. Hunching over and staring at a screen with poor posture for extended periods of time can strain the muscles attached to the back and the result is often lower back pain. These are also examples of habits that can be changed to prevent pain from occurring.

With age, different problems arise due to age-related changes that may be less under your control. One of the more common changes that occurs with age is that the intervertebral discs eventually begin to dry out. These discs are originally soft and squishy to better absorb shock, but over time they lose some of their height and strength, and can no longer take on as much impact. Other changes that usually start to occur in middle age include a narrowing of the space surrounding the spinal canal and a weakening of the joints that connect the vertebrae together. As a result of all of these age-related changes, a number of other conditions become more likely to strike, such as:

  • A herniated disc: occurs when some of the softer jelly-like substance pushes out through a tear in its tougher exterior, which may or may not cause symptoms
  • Spinal stenosis: the name for the narrowing of the spinal canal, which can put pressure on the spinal cord and lead to pain
  • Spondylosis: a general term used to describe any pain related to age-related changes in the spine, which becomes more common with aging

All of these back-related issues remain likely for older adults over age 65, but other conditions like osteoarthritis and osteoporosis become even more common in later life as well. Osteoarthritis occurs when individuals lose some of the protective cartilage surrounding the ends of the vertebrae, which allows them to rub against one another and often results in pain. Osteoporosis is a condition that causes bones to become weak and brittle, which increases the chances of fractures in the back. Further adding to the potential for back pain in older age is the loss of flexibility that many individuals experience. Reduced flexibility often has a negative impact on activity levels, which can create a vicious cycle of less movement and a higher risk for injuries like back pain.

So as you can see, back pain can occur at any age, and the risk for it increases as we get older. While this may not be the most encouraging piece of news, the most important thing to understand is that you have the power to influence your risk based on the habits and behaviors that define your life.

Seeing PT early for neck pain can lower costs and use of healthcare
January 29, 2019

Neck pain remains one of the most common reasons patients seek treatment

Neck pain is extremely common, as it ranks fourth of all conditions that are responsible for causing disability. As a result, neck pain is also one of the most common reasons that individuals seek out treatment, and the majority of them go to their primary care doctor for an evaluation. Doctors usually recommend medication, additional testing, a referral to a specialist, or some combination of these interventions, but evidence is lacking to support many of the approaches that are used. On the other hand, recently published guidelines recommend many of the interventions used by physical therapists for neck pain—such as education, stretching exercises, and manual therapy—as research has found them to be effective for reducing patients’ costs and their use of healthcare. Seeing a physical therapist early is also generally recommended, but research evaluating how the timing of going to therapy affects costs and healthcare usage on neck pain patients is lacking. For this reason, a study was conducted to investigate the impact of seeing a physical therapist at different points in time on costs and healthcare use.

Patient records are collected and analyzed

To conduct the study, researchers scanned medical records to identify patients with neck pain who sought out care from a physical therapist, and they found 308 that fit all the necessary criteria. Once the patients records were collected, the researchers divided them into three groups depending on when the patient consulted with a physical therapist: 1) early physical therapy (for those who saw a therapist within 14 days of first seeing a medical professional), 2) delayed physical therapy (between 15-90 days), and 3) late physical therapy (91 days or more). Using these groups, data from the patients was then analyzed to determine if there were any associations between the time it took for them to see a physical therapist and their overall usage of healthcare services over one year. They particularly focused on opioid prescriptions, spinal injections, and imaging tests (X-rays, MRIs, and CT scans), as well as the overall costs of these services for each patient.

Patients with neck pain are encouraged to see a physical therapist early to save on costs and avoid unnecessary interventions

Of the 308 patients in the study, 160 (52%) consulted a physical therapist within 14 days for their neck pain, while 74 (24%) did so in 15-90 days, and 74 (24%) waited for more than 90 days. In general, results showed that those who saw physical therapist early typically underwent fewer treatments and tests, and spent less on their care compared to those in the “delayed” and “late” groups. More specifically, it was found that consulting a physical therapist late (>90 days) for neck pain was associated with a more imaging tests, spinal injections, and opioid prescriptions, all of which added up to more healthcare utilization. In addition, patients in this late physical therapy group spent an average of $2,172 more on healthcare over one year compared to those in the early physical therapy group who consulted within 14 days. Taken together, these findings suggest that when a patient sees a physical therapist early for their neck pain rather than waiting, they may be reducing their chances of undergoing tests and treatments that may not be necessary, and saving on healthcare costs as a result. Patients who currently have neck pain are therefore encouraged to consult with a physical therapist as soon as possible so they can get started on a personalized treatment program right away while avoiding additional interventions that have questionable value.

-As reported in the November ’18 issue of BMC Health Services Research