Posted on 10/02/2023 7:28:46 PM PDT by ConservativeMind
Patients who first seek physical therapy or chiropractic care have better outcomes and shorter episodes of acute care for low back pain, according to research.
The findings show that for patients with acute episodes of low back pain, the first point of entry to the health care system is associated with utilization and total cost of care in the following year. Clinical practice guidelines prioritize nonpharmacologic and nonsurgical treatments. Patients are often prescribed opioid pain medications or referred to specialists for procedures—including surgery, imaging or steroid injections—that do not address the root causes of their pain.
By combing through nearly 30,000 patient records, Bise and his team found significant differences in health care utilization depending on where patients initially sought care for acute back pain relief.
People who first sought specialty care (rheumatology, physiatry or pain management) were in pain for nearly twice as long as those who first went to the emergency department, chiropractic care or physical therapy. However, when comparing total costs, those who first sought care through the ED or surgery paid nearly twice as much as those who entered through chiropractic care or physical therapy.
Patients seeking care through the ED were also more likely to have high-cost imaging and injections. Additionally, more than half of ED patients filled prescriptions for opioid pain medications, compared to just 11% for people who sought chiropractic care and physical therapy first.
"Often, patients with low back pain end up spinning in the system, going from one specialist to another," said Christopher Standaert, M.D. "Their care costs a tremendous amount of money, but they're not getting any better."
(Excerpt) Read more at medicalxpress.com ...
It does seem that if you have a hammer, everything is your nail.
Just N=1, but I saw a physiatrist who prescribed an MRI, a low-dose NSAID, and physical therapy. At best, the PT did nothing, and on most days it made the pain worse (and there was no short-term pain that led to eventual improvement, just pain). I had 8 weeks of PT and my pain only improved when I stopped.
It held until I foolishly lifted some heavy objects, and the pain was next addressed by an epidural steroid injection. Other than occasional mild discomfort, so far, so good (3 months post-injection).
Oh, my achin' back! This headline isn't even grim humor to me.
All PT did was delay the time when my stenosis was finally relieved by a laminectomy. By YEARS, that I will never get back. (pardon the pun)
And don't you DARE mention chiropractic within earshot.
SNORT! I’ll add my sad tale of woe over opting for physical therapy. Never again. I’m another one who found that the pain and disability was only aggravated to a magnitude of 10 because of that. More...I now suffer from severe sciatica down both legs and can’t walk 75 feet to the mailbox and back. I now rely on a electric scooter to check the mail or go to the supermarket for groceries. And don’t even get me started on how chronic paid is not managed these days. Positively inhumane and barbaric.
I asked my doc if I could try PT first, and she said fine.
For me? Best decision ever. I was barely walking and in major pain. The PT made an excellent diagosis, and we went from there.
I saw improvement each week. At first, I couldn't climb stairs and often walked with a cane (I hated that).
Through the application of various stretches, exercises and biweekly visits to a competent masseuse, I was taking stairs two by two in 5 weeks and skiing in 7 or 8.
And, I learned a ton (I've been walking and running incorrectly for over 70 years.)
No MRIs, no meds, steady improvement.
Your results could be different, but the PT worked well for me.
My first series of 3 epidural shots lasted nearly 6 years. Just got two shots a few months ago and have greatly reduced pain and decent mobility. (Bad discs and nerve sacks on the spine).
One proposed spinal fusion procedure could either cure one problem area (discs 1 and 2, upper neck, paralyze me or kill me. I never flipped that coin for any of them).
I do dead hangs or I’ll stretch over a big beach ball. I used to have lower back pain from sitting too much. But these procedures have removed the lower back pain.
I was having trouble with my rotator cuff. I knew it wasn’t bad enough for surgery, and yet it was interfering with daily activities.
I asked my doctor if he thought PT would help and he said yes and sent me for it.
That was a couple years ago and I have not had a bit of trouble since then. It worked wonders.
Back pain is often caused by having a weak core, in which case yoga and planking can make a huge difference.
My Dad, who had chronic back pain, swore by holding on to the side of the pool with light weights on his ankles. YMMV. I agree about core strength.
This machine works wonders: https://allcore360.com. If you can find a therapist who has one near you. They’re pretty rare, but catching on.
“My first series of 3 epidural shots lasted nearly 6 years. Just got two shots a few months ago and have greatly reduced pain and decent mobility. (Bad discs and nerve sacks on the spine).
One proposed spinal fusion procedure could either cure one problem area (discs 1 and 2, upper neck, paralyze me or kill me. I never flipped that coin for any of them).”
That’s encouraging, regarding how long the epidural shots lasted. I’ve got osteoarthritis/spinal stenosis in the lumbar area. After shots are no longer an option, the doc mentioned nerve ablation as a possible next step (he’s a minimally-invasive therapist).
With that potential (bad) outcome, it makes sense that you wouldn’t opt for surgery. Generally speaking, for every person who benefits from back surgery, it seems there are 20 who say they’re worse off and wish they hadn’t done it. Rock and a hard place...
I have a German Sheperd that sheds quite a bit, so before I can do any exercising I need to vacuum the carpet. I find this helps my back enough that I can skip the exercise and I can sit down and watch TV from my recliner. :) All kidding aside, mornings are rough, sitting less and doing exercise does help, might not cure it but if you do it on a regular basis it helps. Lots of videos on YouTube, and yes vacuuming does help some to get moving in the morning.
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