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  • Exercise Trumps Surgery in NPR Report on Back Pain

    The idea that exercise can be more effective than surgery as a way to manage back pain may be well known to physical therapists, but National Public Radio (NPR) has spread the word to a much wider audience.

    A report broadcast on January 13 features the stories of several patients who suffered from back pain, some of whom underwent surgery for their conditions. In all the cases featured, exercise was the only factor that brought relief or helped them manage the pain.

    Reporters Patti Neighmond and Richard Knox focused on a "back pain bootcamp" program run by James Rain, MD, a physiatrist near Boston. The program is focused on rehabilitative techniques that reporters say help individuals "learn to ignore their pain."


    • We knew it all along!!!!!

      Posted by Daniel Walsh -> =KV`BO on 1/14/2014 9:23 PM

    • I'm 67yr old female gardener with lumbago. T11/12. L1/2, L2/3, L3/4, L4/5, L5/S1 bulging disc with degenerative facet changes & hypertrophy of ligamentum flavum causing slight narrowing of the canal. No stenosis. Severe pain in hips and back and so far Ibuprofen/Mobic is my only savior. Sitting hurts the most, walking, laying, bending, lifting. Stretching feels good but doesn't help for long. Would love to have a support group and am willing to follow a daily routine. I've suffered with back pain for 6 yrs and just recently had MRI showing the bulging disc. Drs want to wait and see if pain goes away with Mobic and exercise, or pain becomes more severe, then will refer me to spine or back dr. Chriopractor helps with the stretches 2x's week. Wish I had access to aquatic exercise. I think I could handle that. Not sure about a bootcamp, sounds rough.

      Posted by Jeanie Paterniti on 1/14/2014 11:31 PM

    • If the referring physician is clear with the patients that pain does not equal harm, these patients do well. We have a Behavior Health and Persistent Pain education component in our program to deal with "castrophizers" and kinesiophobia. Am grateful to NPR for writing this story.

      Posted by Cathy Zarosinski on 1/17/2014 3:38 PM

    • Back pain is a symptom, not a diagnosis. The diagnosis for idiopathic low back pain is a commonly overlooked, reversible, biomechanical lesion of the sacroiliac joint with an anterior rotation of the innominates on the sacrum on an acetabular axis. Relief with correction is immediate. My program for patients will have them much improved or free of pain within three days without professional assistance. Early research is filled with errors in biomechanics, structure, measurement and testing. For x-rays of normal SIJ movement in the long straddle position I invite you to visit. www.thelowback.com How it works, why it hurts and how to fix it.

      Posted by Richard DonTigny, PT on 1/17/2014 5:10 PM

    • Heard the news report. Well done - good health promotion for the profession of Physical Therapy!

      Posted by Linda Berezny on 1/17/2014 6:53 PM

    • This is not for all low back pain. Research tries to lump all low back pain pathologies together and some may do better with surgery and some with exercise. There needs to be better research on this. What the patient does in their everyday life is also a factor here as well as orthotic adjuncts.

      Posted by Timothy Hoerner -> AFQbB on 1/17/2014 7:40 PM

    • I have been a PT for 43 yrs. and some years ago I saw a shift pushed by lower reimbursements and other factors. We started ignoring pain while pushing for improved strength,motion and function. At my clinic we help patients with chronic pain to actually reduce their pain with gentle manual techniques which then allows them to function better. It is a sad state in our profession when we disregard our patients' pain.

      Posted by Richard Fowler on 1/18/2014 9:45 AM

    • PT's have not done their profession or themselves, and certainly not their patients, any favors when they treat patients as numbers of units which translates into dollars. If PTs are truly interested in the patient's well-being and take the time to stay well-trained (i.e. evidence-based), take the time to be thorough evaluators, and innovative interventionalists on an INDIVIDUAL basis with the patient, we wouldn't have to wait for research or surgical failures to make us look good and promote our profession to the status it deserves....

      Posted by Beth PT on 1/18/2014 12:18 PM

    • Kudos for this article as the cost of treating back pain in the USA has long been totally ridiculous based on unnecessary surgeries and various injections, radio frequency ablation, and implant stimulators. I have been in practice for 28 years and have used the McKenzie Method for 28 years. Not only does the McKenzie Institute now have the research to support the effectiveness of this method, but the IMC clinics in Jacksonville Florida under Mark Miller's direction have now become the No 1 choice for several Large insurance companies to treat their spine patients. A pilot study was done in 2006 and using the McKenzie/mechanical diagnostic treatment approach, the Centers for Orthopedic Sports Physical Therapy were able to save Capital Health Plan over a million in treatment of their insureds'spines. They reduced surgeries by 45%,they reduced imaging 86%, patient satisfaction was 97%. Further care was reduced 80% over the reported 60%. Furthermore their Average number of treatments was only 5.1 for the 2800 cases the COSPT clinics provided for the CHP insureds. This is nothing short of phenomenal!! I have had this success with mechanical diagnostic therapy and have prevented hundreds of patients over the years from ever having surgery. What is so frustrating to me is my results no longer garner referrals so my tiny private practice. I never had to advertise for decades, but now the big corporate entities are taking over, the quality of therapy declines and the number of patients seen in a day by one PT has become mind boggling to me. Health Insurance Companies are the rulers of health care here in Kentucky. The doctor nor physical therapist has the say when companies like Humana disregards the MD/PT orders and POT. Humana/Orthonet dole out visits at 4-5 per episode, then demand lengthy up dates before they Might award another 4-5 visits....and ALL at one flat rate of $70/per visit. Some patients have co pays as high as $50, so Humnana is 'out' $20? for an hour of my time!?! The private insurance Medicare replacement plans from Humana only pay the $70, and then they bill MC for 117% of the MC allowed amount. How Long will it take for government to WAKE UP and take control of this rip off of our MC funds and disservice to their insureds as well as providers losing money daily treating these cases?? YES exercise and manual therapy is INDEED the first approach that should be taken for our spine patients and the billions spent on back care each year could be reduced Significantly.

      Posted by Glenda Elswick, PT, OCS, Cert MDT on 1/19/2014 5:39 PM

    • I totally agree. The changes for MC have put a big burden on the insured. Physical therapy with Empire Mediblue now makes us pay 55 as the co pay. So with six visits over two weeks it's a bit much. It has restricted people who need PT to avoid going to get treatment. As a result the problem gets worse.

      Posted by MK on 2/6/2015 9:02 AM

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