By Chloe Tuma, DPT
Low back pain can be debilitating and frustrating. It is also incredibly prevalent. A published study reported that over 577 million people suffered from low back pain in 2017. While you may not be alone in your battle with low back pain, recent research is pointing to a consistent trend – spending more money to resolve your low back pain typically does not yield better results. Seeking physical therapy treatment first for low back pain does!
YOUR LBP DIAGNOSIS DOESN’T DEFINE YOU
If you are suffering from low back pain, naturally, you want to know the cause. Put simply, your mind wants “a diagnosis.”
Common medical diagnoses of low back pain include:
- Herniated disc
- Osteoarthritis
- Osteoporosis
- Spinal stenosis
- Degenerative joint disease (DJD)
- Degenerative disc disease (DDD)
However, your diagnosis does not define you. Surprisingly, these diagnoses can occur in the absence of low back pain and often do. That’s right, you can have DDD or DJD and have absolutely no pain. In our clinics, when we point out this fact, it often surprises our patients. But, it shouldn’t. By age 40, the vast majority of us have a disc herniation but have no back pain. When low back pain strikes, try letting go of the desire to have your pain “defined” and focus on the important part, getting better.
SAVE MONEY WITH LOW BACK PAIN
Knowing that your diagnosis does not define your low back pain will help you understand this next key point. Seeking diagnostic imaging (like MRI or x-rays) as a first strategy to resolve low back pain leads to higher costs. A great blog by choosept.com explains why those who receive an MRI before seeking physical therapy spend an average of $4,793 more than those who seek physical therapy treatment before imaging. Even more important is that both groups achieved similar outcomes. Starting with physical therapy gets you on the path to feeling better.
When is expensive testing necessary? While physical therapy is the right place to start for low back pain, there are specific situations when additional testing or interventions are needed. Your physical therapist can help identify if or when you may need additional testing or intervention and refer you to the best provider. Some rare, but important-to-know symptoms can accompany low back pain. In these unusual situations, you should seek emergent care:
- A sudden change in bowel or bladder symptoms that accompany low back pain
- Numbness or tingling in the “saddle” region (think riding a horse)
SAVE TIME WITH LOW BACK PAIN
Our natural tendency when we experience low back pain is to “wait it out.” While this may be true for a few days to a week, waiting too long can cost you time and money. Interestingly, treating specific types of low back pain with manipulation therapy in the first 16 days can help resolve your problem faster. PTs are trained to identify whether your low back pain fits these criteria. Two of the five factors include those with low back stiffness and whose pain does not refer past the knee. More importantly, multiple studies have identified that, with this type of low back pain, not performing manipulation therapy within the first 16 days can result in a worse outcome overall. Check out this resource from the APTA on how we identify which type of low back pain will benefit from early intervention with spinal manipulation therapy.
What does that mean for you? First, meet with a physical therapist within the first two weeks from the start of your low back pain. Second, choose a physical therapist who is specifically trained in the management of low back pain using spinal manipulation therapy. Your PT can quickly identify if you are a good candidate and start treatment right away. Many physical therapy clinics that specialize in treating low back pain will meet with you for free because they understand the consequences of waiting too long.
HOW DOES PT HELP LOW BACK PAIN
If you are suffering from low back pain, you may not fully understand what physical therapy is and how it helps. You’re not alone. Physical therapy treatment for low back pain can look very different from one clinic to the next. For best results, choose a physical therapist that specializes in back pain and a clinic that offers many different types of treatment. Here are just some of the therapies we use for low back pain:
- Spinal manipulation
- Joint mobilization
- Soft tissue mobilization
- Dry needling
- Aquatic (pool) therapy
- Therapeutic exercise (strength and flexibility)
- Balance retraining (neuromuscular education)
DO I NEED A REFERRAL?
Each state’s requirements are different. In Minnesota, no referral is required to see a physical therapist. However, some insurance plans still require a referral or physician’s approval to pay for care. If you are unsure but want to get seen quickly, we recommend scheduling a free 15-minute screening appointment. Because there is no cost, you can meet with a physical therapist one-on-one to assess your low back pain and get your questions answered. If physical therapy is right for you, our team can help answer questions about cost and navigate insurance steps as well.
Chloe Tuma, Doctor of Physical Therapy, Certified in Dry Needling
