A British screening approach for physicians with patients complaining of low back pain (LBP) could help in creating a US approach that more frequently involves physical therapists (PTs) early on and lowers the financial burden of the condition, according to an editorial appearing in the April issue of The Annals of Family Medicine.
In their editorial, "Physical Therapy for Low Back Pain: What Is It, and When Do We Offer It to Patients," authors Timothy S. Carey, MD, MPH, and Janet Freburger, PT, PhD, comment on a new study of PT management of patients with LBP, saying the results represent an "important incremental step" in validating approaches that involve PTs early on and reduce patient work time lost. The approach described in the study involves physician use of a British screening tool known as the STarT, which can help a physician assess LBP. Once that key assessment is made, a medium or high-risk patient can be referred to a PT for effective treatment.
The editorial answers the question "Should we try to adopt such an approach in the United States" with "a qualified yes." Authors point to logistical and regulatory wrinkles that would need to be worked out, but they say that similar screening approaches—such as those used for alcohol use or depression—were implemented fairly easily. "These advances don't solve our problems with the large disability burden and high cost of low back pain," the editorial states, "but they represent a promising start."
APTA offers synthesized evidence-based information on LBP through PTNow, including clinical practice guidelines developed by APTA's Orthopaedic Section. Other LBP guidelines can be accessed at PTNow's practice guidelines webpage.
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