In a retrospective cohort obtained from electronic medical records and insurance claims data, initial physical therapy management following a new primary care low back pain (LBP) consultation was not associated with increased health care costs or utilization of specific services. The authors of this article, which appears online in Archives of Physical Medicine and Rehabilitation, write that additional research is needed to examine the cost consequences of initial management decisions made following a new consultation for LBP.

Records and data were examined on 2,184 patients aged 18 and older with a new consultation for LBP from 2004-2008 in single health care delivery system in the United States. Patients were categorized as receiving initial physical therapy management if care occurred within 14 days after consultation.

Total health care costs for all LBP-related care received in the year following consultation were calculated from claims data. Predictors of utilization of emergency care, advanced imaging, epidural injections, specialist visits, and surgery were identified using multivariate logistic regression. Generalized linear model was used to compare LBP-related costs based on physical therapy utilization and identify other cost determinants.

Initial physical therapy was received by 286 of 2,184 patients (13.1%) and was not a determinant of LBP-related health care costs or utilization of specific services in the year following consultation. Older age, mental health or neck pain comorbidity and initial management with opioids were determinants of cost and several utilization outcomes.

APTA member Julie M. Fritz, PT, PhD, ATC, is the article's lead author. APTA members Gerard P. Brennan, PT, PhD, Stephen J. Hunter, PT, DPT, OCS, and John S. Magel, PT, DSc, OCS, FAAOMPT, are coauthors.