Low back pain is the most common condition that I see when I am referred patients. With such a prevalent problem, a significant amount of research has been conducted in my field to determine the best way to treat low back pain.
The resounding finding from our research is that if you have low back pain that is recent in nature (less than 30 days), it is vital to see a Physical Therapist who is well-trained as your chances of full resolution of symptoms increase. Furthermore, just by seeing a Physical Therapist first, the average cost of care for low back pain reduced by $2,736……. $2,736!1 That’s a huge number! This number can be reduced by a further $1,374 if a research-based classification system is used to guide treatment.
The question that you may be thinking at this point is what does a Physical Therapist do differently that allows this discrepancy in care and cost. The first thing I do is take measures to determine how you, as a person, are responding to your low back pain. People are not simple. Pain is not simple. Pain is determined by the brain and not at the site of tissue damage, thus why different people experience pain in different ways. Our values, beliefs, fears, experiences, and emotions all shape how your brain processes pain. By determining how you are responding to your low back pain, I can determine if there are other underlying issues other than a tissue injury that are influencing these pain symptoms. If these are present, more time will be spent on education on pain science. If not, I move to a classification scheme to best determine how to treat your low back pain2.
The classification scheme consists of three main categories: a manipulation group, a stabilization group, and a repeated movements group. Curious which group you are in? Check out this quick test to determine where you may fall. (https://www.therapeuticassociates.com/programs/low-back-pain-revolution/)
Your first visit in the clinic is used to determine which group you are placed in. Research actually shows that by placing you in one of these treatment groups you will achieve a better result3. Here’s the nitty gritty on the groups:
- Manipulation Group: In this group you will most likely benefit from a manipulation. A manipulation is a short, quick movement to your spine. Performing this technique, combined with follow-up mobility exercises, leads to incredibly good results. On average, 95% of patients are fully resolved in 2 visits!
- Stabilization Group: In this group you will most benefit from exercises to ensure proper muscle activation, movement patterns, and strength through your low back. By ensuring all of the muscles are working properly the joints of the back become much better supported and injuries are reduced.
- Repeated Movement Group: In this group you will be given specific movements that reduce the pain you are feeling, which many times consists of pain that has travelled into the thigh and legs. These movements are determined through your response to tests given in the evaluation and quickly start to eliminate the pain that is radiating to other places, such as down the leg.
Bottom Line: if you have low back pain that started less than 30 days ago a visit to Physical Therapy can ease your pain while also saving you time and money.
What do you do if you have had low back pain longer than 30 days or don’t seem to fit into a treatment category? Stay tuned for our next blog post-Part 2!
As always, if you have questions regarding your health you are always welcome to contact me directly.
Fritz JM, et al. Primary care referral of patients with low back pain to physical therapy. Spine. 2012;37(25):2114-2121
Delitto, A., Erhard, R. E., & Bowling, R. W. (1995). A Treatment-Based Classification Approach to Low Back Syndrome: Identifying and Staging Patients for Conservative Treatment. Physical Therapy, 75(6), 470-485.
Fritz JM, Cleland JA, Childs JD. Subgrouping patients with low back pain: evolution of a classification approach to physical therapy. J Orthop Sports Phys Ther. 2007 Jun;37(6):290-302.