In January of 2016, Nick Watney, a professional golfer with over $25 million in career earnings on the PGA Tour, took the approach to rehabilitate his lower back with physical therapy. He was feeling lower back pain that radiated into his left hamstring area above his knee. An MRI confirmed a disc herniation. He had multiple surgical consults, however ultimately decided on physical rehabilitation. After almost a year away from competitive golf to allow healing and improve his strength and flexibility with exercises, he is back to playing on the PGA Tour on a consistent basis with strong finishes.

Tiger Woods, a well-known professional golfer with 4 times the career earnings as Nick Watney elected to have surgery in March of 2014 to relieve nerve pain into his lower extremity. Four surgeries later and a lumbar fusion in 2017 has led to his indefinite absence from the PGA Tour.

The annual cost to the US economy for direct medical and associated costs of lower back pain is an astounding $135 billion4. Lower back pain is the 5th most common reason for physician visits in the US4. One in four people will experience lower back pain at any given time and 80% of individuals experience lower back pain in their lifetime4.

Traditional treatment for lower back pain has involved over the counter medications, rest/wait and see approach, imaging, injections and surgical procedures. These are considered either passive treatments or only treating symptoms. Passive treatments have been shown to be inferior to active treatment approaches (exercise) in recent literature. Seventy-five percent of patients with lower back pain treated passively did not fully recover after 12 months. In addition, 25% of lower back surgeries will require an additional surgery1.

Recent physical therapy research has found early intervention to a physical therapist within 14 days of injury to have a cost savings of $2736 per case3. A clinical prediction rule for lower back pain has been recently developed in the research. A physical therapist following this treatment based classification system can evaluate the patient to see if they fit 4 criteria of musculoskeletal impairment (low back/hip stiffness, location of pain and duration). If a patient meets these 4 criteria, they have a positive likelihood ratio (+LR) of 24.38 when treated with manual therapy and exercise2. This means, they are 24 time more likely to have a successful outcome with treatment than if they do not have these factors present. A likelihood ratio of 4 in the literature is considered significant.

At Therapeutic Associates Sellwood Physical Therapy, our physical therapist will perform a comprehensive lumbar scan to help direct your care. They will use the latest research techniques when treating and classifying low back pain to help you reach your pain and functional goals.

Feel free to reach out to us at [email protected] or (503) 236-3837.


  1. Blackmore CC, Mecklenburg RS, Kaplan GS. At Virginia Mason, Collaboration Among Providers, Employers, And Health Plans To Transform Care Cut Costs And Improved Quality. Health Affairs. 2011;30:1680-1687.
  2. Childs JD, Fritz JM, Flynn TW, et al. A Clinical Prediction Rule To Identify Patients with Low Back Pain Most Likely To Benefit from Spinal Manipulation: A Validation Study. Annals of Internal Medicine. 2004;141:920-W-166.
  3. Fritz JM, Childs JD, Wainner RS, Flynn TW. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. Spine. 2012;37:77-82.
  4. Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Archives of physical medicine and rehabilitation. 2005;86:1753-1762.