The Value of Physiotherapy- Low Back Pain
July 22nd, 2014 - Posted in Uncategorized
Four out of five Canadians experience at least one episode of low back pain (LBP) at some point in their life.1 Physiotherapy for patients with LBP is effective in reducing both acute and chronic pain while significantly limiting the risk of increased disability and chronic conditions.
Role of Physiotherapy in the Management of LBP
Physiotherapy has a primary role in the management of and recovery from LBP. Interventions focus on pain relief and the prevention of future occurrence of pain and injury, as well return to Physiotherapy management of LBP includes assessment and diagnosis, exercise prescription, education, self-management strategies, workplace intervention, manual therapy and modalities.
Physiotherapists may also triage LBP patients to ensure they receive the most appropriate treatment, conservative or surgical management.2 Physiotherapist-led spinal triage clinics reduce wait times to outpatient orthopedic departments, reduce the ordering of unnecessary diagnostics and enable early access to physiotherapy by directing patients to conservative management treatment options in a timely manner.3
Impact on Patient Experience
Physiotherapists provide patient-centered care in the management of LBP.
• Physiotherapy reduces pain and improves function, for acute and chronic LBP.4,5
• Patients value prompt access to physiotherapy for new episode of LBP in primary care in particular for reassurance provided.6
• Physiotherapists working in a triage role in collaboration with orthopedic surgeons effectively manage the care of LBP patients, decrease wait times for specialized care and diagnostics and improve health outcomes and patient satisfaction.2,7,8
Impact on Population Health
Early access to physiotherapy management of LBP has a significant long-term impact on health, by preventing chronic disability and decreasing the proportion of acute LBP cases that become
• Physiotherapy reduces pain, disability and time off work, and improves quality of life.5
• Physiotherapy management of LBP reduces pain and improves function.9
• Physiotherapists create individualized programs with a focus on self-managment
and maintenance of health resulting in positive lifelong lifestyle changes.5,9
The Value of Physiotherapy- Impact on Health Care Costs
Early access to physiotherapy for LBP is cost effective and results in reduced physician visits, lower number of surgical interventions and earlier return to work. • Early access to physiotherapy reduces the number of days of sick leave compensation for sub-acute LBP by 43.9 days per person over a three-year period due to a faster rate of return to work within the first year.10
• Early access to physiotherapy (within 14 days) for LBP reduces health care utilization by reducing medication use, physician visits, use of advanced imaging, and injections.6,11
• Total medical costs are $2,736.23 lower for patients receiving early physiotherapy.11
• Physiotherapists working in spinal triage clinics provide a cost-saving method of delivering care and reduce the volume of surgical referrals.2,7,8
Summary
Evidence suggests that physiotherapy reduces severity of LBP pain both in the short and long
terms, thereby improving quality of life while reducing overall health care costs. The economic burden of LBP is significant and continues to grow with indirect costs, as a result of lost work productivity, representing the majority of overall costs associated with LBP. Investment in early access to physiotherapy is a cost-effective strategy to reduce the economic burden of LBP.
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pain disability: a pragmatic randomized trial with economic evaluation. Spine. 2007 Jun 15;32(14):1474-81.
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a prospective randomized clinical trial. Clinical Journal of Pain. 2006; 22 (6): 505-11.
9. Molde Hagen E, Grasdal A, Eriksen H. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3
year follow-up study. Spine. 2003 Oct 15;28(20):2309-15.
10. Fritz J, Childs J, Wainner R, Flynn T. Primary care refeeral of patients with low back pain to physical therapy: impact on future health care
utilization and costs. Spine. 2012; doi: 10.1097/BRS.0b013e31825d32f5
Canadian Physiotherapy Association 2012
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The Value of Physiotherapy
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