February 5, 2013
APTA takes exception to the portrayal of ultrasound, Tiger Balm patches, and bumpy balls as "cutting-edge physical therapy treatments" for back pain in your recent segment "Cutting-Edge Solutions for Back Pain."
While modalities may be used by physical therapists as part of an overall treatment plan, the focus of physical therapy treatment for back pain is on evidence-based exercises to improve strength and flexibility, manual therapy to improve the mobility of joints and soft tissues, and patient education on ways to enhance recovery, prevent and relieve pain, and avoid recurrence. These avenues of care offer long-term solutions rather than temporary, intermittent relief.
In addition, physical therapists advocate an individualized approach to treating back pain. Each patient is unique and is much more than the pain that he or she experiences. Patient goals, preexisting conditions, and comorbidities must be taken into account in order to provide patients with a valid, nonsurgical option that can restore and improve motion. The Low Back Treatment Guidelines published in the Journal of Orthopedic and Sports Physical Therapy clearly illustrate this approach.
Also noteworthy is a 2012 study published in the scientific journal Spine showing that early access to physical therapy by patients with low back pain improved patient outcomes and decreased health costs. Other studies have shown that physical therapy can be a cost-effective alternative to long-term use of prescription drugs or surgery. For instance, a 2012 study, also appearing in Spine showed that patients who received physical therapy soon (within 30 days) after an episode of acute low back pain had a lower risk of subsequent medical service usage (surgery or epidural steroid injections) than did patients who received physical therapy after a longer period of time had elapsed. In addition, a 2010 study in the Journal of the American Medical Association (JAMA) highlights the rise of complex and risky spinal fusion surgeries among Medicare patients with simple spinal stenosis, confirming the need to look at alternative methods of treatment such as physical therapy.
It is vital that consumers are made aware of the fact that physical therapists can help them with their back pain. To that end, we are pleased that Dr. Oz sought the advice of a physical therapist. However, viewers would have been much better served had they been educated on the breadth of evidence-based treatment approaches and the customized care available to them from a physical therapist.
Your viewers may learn more about conditions physical therapists treat and find a physical therapist in their area by visiting www.moveforwardpt.com.
Paul A. Rockar, Jr, PT, DPT, MS
American Physical Therapy Association