ArticleBMC health services research2022
Initial presentation for acute low back pain: is early physical therapy associated with healthcare utilization and spending? A retrospective review of a National Database.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 30 citations in OpenAlex.
- Article
- Initial Treatment for Acute Low Back Pain and Risk of Opioid Use Disorder and Overdose.JAMA network open · 2026Article
- Predictive factors for care intensification in a no co-pay physical therapy model for musculoskeletal pain.BMC health services research · 2026Article
- Health care epidemiology, characteristics, and regional variation of chiropractic care in Switzerland: a descriptive study using insurance claims data.BMC health services research · 2026Article
- Digital Versus In-Person Physical Therapy in Adults With Musculoskeletal Conditions: Retrospective Matched-Cohort Analysis of Surgery and Low-Value Surgical Rates.Journal of medical Internet research · 2025Article
- Episode of Care Characteristics Following Implementation of a No Copay Physical Therapy Program for Musculoskeletal Conditions.Physical therapy · 2025Article
- Factors Associated with Radiological Examination of Patients with Non-Specific Low Back Pain.Journal of clinical medicine · 2025Article
- Clinical and Economic Outcomes Associated With Musculoskeletal Care in an Integrated Advanced Primary Care Model: Controlled Cohort Analysis.Journal of medical Internet research · 2025Article
- Increasing Methodological Transparency and Openness in Rehabilitation-Related Health Services Research Using Claims Data: A Case Example.Physical therapy · 2025Article
- Real-World Effect of a Digitally Delivered Conservative Musculoskeletal Care Program on Spinal Diagnostic Imaging Utilization in a Commercially Insured Population with Chronic Back Pain.Journal of health economics and outcomes research · 2025Article
- Key Factors Driving Physiotherapy Use in Patients with Nonspecific Low Back Pain: Retrospective Clinical Data Analysis.Journal of clinical medicine · 2024Article
- Preliminary Validity and Acceptability of Motion Tape for Measuring Low Back Movement: Mixed Methods Study.JMIR rehabilitation and assistive technologies · 2024Article
- On-Site Physiotherapy in Emergency Department Patients Presenting with Nonspecific Low Back Pain: A Randomized Controlled Trial.Journal of clinical medicine · 2024Article
- Clinician approaches to new spine pain cases in primary care: Balance of opioid prescribing and early linkage to exercise therapy and spinal manipulation.Journal of evaluation in clinical practice · 2024Article
- Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study.Implementation science communications · 2024Article
- Referral of people with low back pain to physical therapists in Brazilian primary healthcare: A challenge revealed.Brazilian journal of physical therapyObservational
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEarly initiation of physical therapy (PT) has been associated with lower healthcare costs and utilization; however, these studies have been limited to single institutions or healthcare systems. Our goal was to assess healthcare utilization and spending among patients who present for the first time with low back pain (LBP), according to whether they received early physical therapy (PT), using a large, nationwide sample; and geographic variation in rates of early PT and 30-day LBP-related spending.
methodsUsing the Truven MarketScan database, we identified nearly 980,000 US adults ages 18-64 years who initially presented with acute LBP from 2010 through 2014 and did not have nonmusculoskeletal causes of LBP. Approximately 110,000 patients (11%) received early PT (≤2 weeks after presentation). We compared healthcare utilization and spending at 30 days and 1 year after presentation between patients who received early PT and those who did not. Alpha = 0.05.
resultsAt 30 days, early PT was associated with lower odds of chiropractor visits (odds ratio [OR] = 0.41, 95% confidence interval [CI] = 0.40-0.42), pain specialist visits (OR = 0.49, 95% CI = 0.47-0.51), emergency department visits (OR = 0.51, 95% CI = 0.49-0.54), advanced imaging (OR = 0.57, 95% CI = 0.56-0.58), orthopaedist visits (OR = 0.67, 95% CI = 0.66-0.69), and epidural steroid injections (OR = 0.68, 95% CI = 0.65-0.70). At 1 year, early PT was associated with less healthcare utilization. At 30 days, patients with early PT had lower mean LBP-related spending ($1180 ± $1500) compared with those without early PT ($1250 ± $2560) (P < 0.001). At 1 year, LBP-related spending was significantly less among patients who did not receive early PT ($2510 ± $3826) versus those who did ($2588 ± $3704). Early PT rates (range, 4-25%; P < 0.001) and 30-day LBP-related spending differed by state (range, $421 to -$410; P < 0.001).
conclusionEarly PT for acute LBP was associated with less 30-day and 1-year healthcare utilization and less 30-day LBP-related spending. Early PT rates and 30-day spending differed by US state. LEVEL OF EVIDENCE: IV.
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