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Effect of Physical Therapy on Back Pain

In this study physical therapists (PTs) compare the cost and effectiveness of routine PT versus advice for patients with low back pain (LBP). This information is important because LBP is the most common cause of disability in adults. Any treatment that works and could save health care dollars would be welcome.

Patients were divided into two groups. The first (advice) group was told to keep active. The second (PT) group was given standard PT treatment including joint mobilization, manipulation, soft tissue therapy, and exercise. Stretching, heat or cold, and advice were offered if appropriate based on a physical exam.

Cost of treatment included payment to the therapist, cost of time off from work, and cost of any medicines were added up for each patient. The cost of the two groups was compared.

Patients receiving PT reported a higher sense of benefit than the advice group. Even so, there was no difference between the groups in terms of disability. Patients in each group also took the same number of days off work.

The authors conclude PT is more expensive than general advice without an added benefit. Patients with low levels of disability seeking the services of a PT should be given advice first before a series of routine treatments are applied. Results of other studies support the use of manual therapy (joint mobilization/manipulation) for patients with more severe symptoms and/or greater disability.

References: Oliver Rivero-Arias, MSc, et al. Cost-Utility Analysis of Physiotherapy Treatment Compared with Physiotherapy Advice in Low Back Pain. In Spine. May 20, 2006. Vol. 31. No. 12. Pp. 1381-1387.

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