Evidences for Early Physical Therapy & Acute Low Back Pain - .

Evidences for Early Physical Therapy & Acute Low Back Pain

Reference: Zigenfus GC, Yin J, Giang GM, Fogarty WT. Effectiveness of early physical therapy in the treatment of acute low back musculoskeletal disorders. J Occup Environ Med. 2000 Jan;42(1):35-9.

Credit for this review: Bahram Jam, PT (APTEI)

 Here are 3 studies that support early physical therapy.  

Ever wonder why professional athletes, who have a salary of a few million dollars per year, receive immediate physical therapy and rehab following let’s a say a back injury, while patients with work-related injuries are often made to wait several days or weeks before receiving physical therapy and rehab? Is a rapid return to function not as important for an average worker?

This retrospective study evaluated the effects of early physical therapy intervention on treatment outcomes for workers with acute low back injuries. Over 3800 patients with acute low back pain were assigned to one of three groups:

Group I: Very Early PT (1-2 days post-injury)

Group II: Early PT: (3-7 days post-injury)

Group III: Delayed PT (8-197 days post-injury)

"Initiating therapy early in the course of treatment was associated with significantly fewer physician visits, earlier discharge from care, fewer restricted workdays, and fewer days away from work!"


Result #1: Patients in Group I had the fewest physician visits (3 days)...significantly fewer than group II ...further more, Group II had significantly fewer physician visits than Group III (p<0.001).

Result #2: Patients in Group I had the shortest length of therapy (10 days)... significantly shorter than group II ...further more, Group II had significantly shorter case length than Group III (p<0.001).

Result #3: Patients in Group I had the least number of restricted workdays (8 days) ...significantly less than group II ...further more, Group II had significantly less number of restricted workdays than Group III (p<0.001).

Result #4: Patients in Group II & I had significantly fewer days away from work than those in Group III (p<0.05).

"The results of this study provide clear and strong indications that the sports medicine approach to rehabilitation, with the emphasis on early intervention and function restoration, could provide a cost-effective way to treat work-related back injuries!"

Other references supporting early PT intervention for acute LBP include:

"This study found that patients with work related musculoskeletal injuries were significantly more likely to return to work within 60 days than patients who were delayed in their referral to PT." (Ehrmann-Feldman et al 1996)

"Compared to those simply given advice to stay active, early physiotherapy intervention led to significantly better outcomes in every area." (Wand et al 2004)

Ehrmann-Feldman D, Rossignol M, Abenhaim L, Gobeille D. Physician referral physical therapy in a cohort of workers compensated for low back pain. Phys Ther. 1996; 76:151-157

Wand BM, Bird C, McAuley JH, Dore CJ, MacDowell M, De Souza LH. Early intervention for the management of acute low back pain: a single-blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. Spine. 2004 Nov 1;29(21):2350-