Treatment for back pain is a $100 billion a year industry.  More people are affected each year and the cost is rising. So isn’t it crazy to think that research has found the best way to treat back pain and that it’s largely ignored? Not a day goes by that I don’t encounter someone who was given the option of “surgery or bust” without any referral to Physical Therapy. There are 18 states with unrestricted access to physical therapy, meaning you do not need a referral. In these states, patients can seek help without a referral (although your insurance company may require one).

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It’s a tough blow to think that so many people haven’t been given the option to heal conservatively. Do you wonder why that is? Unfortunately, most high-volume PT clinics are not set up to successfully treat low back pain. Treatment for low back pain takes a skilled professional and correct execution of one-on-one treatment. Most PT clinics build their business upon seeing as many patients they can an hour, meaning a physical therapist can only spend 20 minutes with their patient before passing them on to a tech. No wonder many of these clinics don't see successful outcomes when it comes to the treatment of back pain.  This is a shame, especially since with the right PT intervention, boatloads of time and money can be saved all while getting the patient back to the life that’s important to them.

Two Approaches to Treating Back Pain

  • Time: Check out this graphic from a study published by the Harvard business review. It depicts the traditional approach to low back pain vs. going to physical therapy first.   

https://hbr.org/2015/07/the-employer-led-health-care-revolution

This study demonstrates that with traditional approach to healthcare, nearly 2.5x the amount of time passes before the patient is on their way to getting better! If going to PT first does not resolve the issue, then the patient can be referred to imaging and a specialist anyway without losing much time. With what we know about chronic injury, the longer a tissue is injured the more unhealthy it becomes. Also, we as humans are adaptable; the more time we spend injured, the more bad movement patterns we adopt to avoid the pain. These movement patterns can lead to problems in the future.

The Overuse of MRI

  • The invention of the MRI was a great stride in medicine. Advanced imaging is fantastic for many conditions, however it is widely overused to diagnose orthopedic conditions. A good PT who uses their physical tests wisely should be able to tell you much of what and MRI will tell you. However, what an MRI will not tell you is if your back pain is caused by the way you squat, deadlift, or golf. The image is a picture of you while you're flat on a table and it only tells you which tissues may be stressed. It can be a great tool as an addition to a movement analysis and treatment plan, but is not necessary unless there is concern of a more serious pathology. Research shows that by choosing PT first, thousands of dollars can be saved.

MRIs Can Be Inconclusive

As if cost and time weren’t enough, there have been studies with patients who had no pain or minimal pain. These individuals went through an MRI which showed some degenerative changes (join the club). After their results were shared with them, they then started to develop pain or discomfort. You’ve heard of the placebo effect? It works the other way as well. The brain is a powerful tool and we need to be aware of that.

The Best Treatment for Back Pain

In summary, what should you do when looking for treatment for back pain? First, physical therapy is absolutely the best way to treat back pain! If you’re lucky enough to live in a state like Arizona you have direct access to physical therapists. There are 18 states with unlimited direct access and 26 states with limited direct access. 

Physical Therapy can save you time, money, and get you back to life quickly. That being said, not all physical therapy is the same. Be sure to research your PT and make sure that you are getting good care. See our blog on how to choose the right PT.  If you’d like to see if you would be a good fit for DPT give us a call or fill out our contact form. We help active people stay active every single day and would be thrilled to help you get back to your life.