Early physiotherapy reduces healthcare costs and opioid use in people with lower back pain

People with lower back pain who see a physiotherapy early on in their treatment go on to cost less in terms of medical services and use less opioid painkillers, says research from the US.

Compared with people who saw a physiotherapist late or not at all, those who saw a physiotherapist at the first point of care had:

• 89% lower probability of having an opioid prescription;
• 28% lower probability of having any advanced imaging services;
• 15% lower probability of having an emergency department visit;
• But they had a 19% higher probability of hospitalisation.

The higher probability of hospitalisation is not necessarily a bad outcome if physiotherapists are appropriately referring patients to more specialised care when low back pain does not otherwise get resolved by addressing musculoskeletal causes first. These individuals had significantly lower out-of-pocket costs, and costs appeared to shift from outpatient and pharmacy towards provider settings.

Lead author, Dr Bianca Frogner, comments:

“Given our findings in light of the national opioid crisis [in the US], state policymakers, insurers, and providers may want to review current policies and reduce barriers to early and frequent access to physical therapists as well as to educate patients about the potential benefits of seeing a physical therapist first.”

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