Doctors Increasingly Ignoring Guidelines for Treating Back Pain Patients

The JAMA Internal Medicine recently published a study that illustrated how physicians are suggesting physical therapy and over-the-counter medicine less and less frequently. According to PT in Motion, the JAMA study illustrates that, ?[d]espite published guidelines that call for physical therapy or medications such as ibuprofen or acetaminophen for first-line management of most back pain, other treatments such as imaging, narcotics, and referrals to other physicians have increased.?

The study also concluded that ?Early physical therapy following a new primary care consultation was associated with reduced risk of subsequent health care compared with delayed physical therapy.?

This report appeared on the JAMA website yesterday.? The study, identifying ?23,918 visits for spine problems,? demonstrated that both treatment with narcotics and physician referrals have grown drastically since 1999, while ?[n]onsteroidal anti-inflammatory drug or acetaminophen use per visit decreased from 36.9% to 24.5%?. During this time, the percent of therapist referrals has remained roughly the same.

Herman & Wallace instructor, Ginger Garner, articulated the problem clearly in her blog: ?What was startling about the study was that while narcotic prescription, referrals for diagnostic tests, and other physician referrals all increased, patient quality of care and back pain outcomes decreased.?? Sometimes PTs are better suited to treat patients than physicians.

The study concluded that, ?[b]ecause more than 10% of visits to primary care physicians relate to back and neck pain, and the treatments recommended by guidelines generally are less costly than those being used increasingly, the financial implications in the health care market are significant.?

Patients now have direct access to PT in all 50 states, but it is important to get the word out to patients and referring physicians that PT is supported as the standard of clinical care for typical low back pain management.