Earlier physical therapy for low back pain doesn’t provide much benefit

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KANSAS CITY, Mo. -- Low back pain is very common.  About 70 percent of us will have it at some point in our lives.  New research shows little benefit in getting physical therapy early.

Roger Weitlich awoke one morning with low back pain that didn't go away.

"I couldn't move right or left. I couldn't lay still. Couldn't stand up," said Weitlich.

He got into physical therapy about a month after the pain started.  That follows current guidelines.

Researchers wondered if patients would do better if they started therapy earlier.  They found it resulted in a little faster improvement in functioning compared to those who waited.  But at a year out, there was no difference between the groups in their levels of functioning or pain.

"The person that wakes up one day and starts having a nagging backache, they're the ones that I think can wait and let's see how that plays out," said Steve Adams, a physical therapist in Kansas City North.

Adams thinks those who have sudden acute pain from lifting or a car crash can benefit from earlier therapy.   He also says those with nagging trouble shouldn't wait much longer than a month to get into therapy.

"You wait and have back pain for so long you start changing the way you move which sets you up for other problems later on," Adams said.

He and researchers also emphasize that pain usually goes away with time.

"They don't need to worry about the surgeries, the injections, the MRIs," Adams said.

Weitlich is glad he didn't rush to surgery.

With time and physical therapy, “I got back to doing the things I love to do,” he said.

That was more than two years ago.  When his pain occasionally returns, he returns for therapy.

The study is in the Journal of the American Medical Association.



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