Finally, Some Good News About Back Pain

Back pain is a huge problem in developed nations worldwide. It has or will affect most of us. The
current estimate is that 80% of people will experience back pain at least once. It is the single
biggest cause for disability, the third most common reason for doctor visits, and one of the most
common reasons for missing work.


It’s also expensive. Back and neck pain makes up the biggest healthcare expense in the US,
totaling $134 billion spent in 2016. The next two most expensive conditions were diabetes —
$111 billion in spending — and ischemic heart disease at $89 billion.


Diabetes and heart disease being so expensive to treat doesn’t surprise most folks – they can
both lead to other major problems, require long term medication, could require surgery, and
both can be fatal. Back pain won’t kill you, usually doesn’t require long term medication, and
usually doesn’t require surgery either. Why is it so expensive?


The first reason is that it’s so common. The second reason is that our current system isn’t very
good at treating it. Current recommendations include starting with activity modification, and
active treatments like physical therapy. Research backs this up, showing better outcomes and
lower costs with early PT. Unfortunately, only 2% of people with back pain start with PT, and
only 7% get to PT within 90 days. At the same time, a study looking at about 2.5 million people
with back pain in JAMA showed that 32.3% of these patients received imaging within 30 days of
diagnosis and 35.3% received imaging without a trial of physical therapy. Both of these things
go against current practice guidelines for treatment of back pain.


A new pilot program being rolled out by TRICARE, the insurance system used throughout the
US military is waiving the payment owed by the patient for up to three PT sessions in an attempt
to improve the use of what the Defense Health Agency calls “high value” treatment for low back
pain. The theory is that once a person sees some benefit from PT treatment, they’re likely to go
back for more. This is the “try it before you buy it” approach – think of the 7-day free trial Netflix
offers, free samples poured in wineries and craft breweries, or the folks you see standing
around in supermarkets with food on toothpicks. TRICARE’s data seems to indicate that it works
just as well for healthcare as it does for other businesses. In a press release they state that
once people attend one session of physical therapy, they’re likely to go back for more, no matter
what their co-pay is. But TRICARE found that higher co-pays could be a barrier to people trying
that first visit. For the group of patients with the highest co-pays in the system, only 38% of the
people prescribed PT attended the first visit. That’s about half the rate of attendance found in
the lowest co-pay group.


The fact that such a major insurer is looking into the value of PT is great news for everyone. If
TRICARE can show that lowering the cost of PT for patients can improve outcomes and save
insurance companies money, other major insurers will likely follow. This could improve the lives
of millions of people every year while reducing the huge cost of treating low back pain for the
country. That seems like a win for everyone involved.

Get PT First During the COVID-19 Pandemic

 

Because of the closures of physician’s offices, stoppages of elective surgeries, and social distancing guidelines resulting from COVID-19, many people with pain or joint issues have had appointments or surgeries delayed. If you’re one of them and you haven’t seen your PT yet, you should. Here are some reasons why:

Early PT leads to better outcomes

Studies have shown that people who receive PT sooner have better outcomes, lower costs, are less likely to have surgery, use opioids or have unnecessary testing. Because back pain is so common, there is a lot of outcome data from people with back pain.  A study of 150,000 insurance claims published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89 percent lower probability of receiving an opioid prescription, a 28 percent lower probability of having advanced imaging services, and a 15 percent lower probability of an emergency department visit. Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days.

Early PT saves money

The rising cost of healthcare is well known and early PT is something that has been shown to reduce costs without reducing the effectiveness of treatment. A study published in the Journal of Orthopaedic and Sports Physical Therapy showed that patients who obtained physical therapy via direct access had significantly lower medical costs—an average of $1,543 less per patient than those who chose referral from a physician. They also had significantly fewer visits and spent significantly fewer days in care.

Surgery may not be as effective as you think

Many patients look to surgery as the fix for their pain, but surgeries aren’t always as effective as patients believe. A large study looking at worker’s comp patients with back pain found that people who have surgery have a 1 in 4 chance of having a repeat surgery, a 1 in 3 chance of a major complication, and a 1 in 3 chance of never returning to work again. Recent large studies of arthroscopic surgeries for meniscal tears have shown no difference in outcomes between people who have surgery and those who don’t. Other procedures with questionable effectiveness include kyphoplasty, vertebroplasty, and injections for nonspecific back pain.

 

So, if you were planning on seeing your PCP or a specialist for an orthopedic condition or pain and you haven’t seen a PT yet, you should consider making PT your first stop. You could end up getting better faster for less money and you might avoid riskier treatments like opioids or surgery.

Life is a Movement Journey, Here’s How PT Can Help

Now that spring has arrived, temperatures are starting to rise in many parts of the country. And
that means the transition from heating our homes to cooling our homes is right around the
corner. No matter what method you use to cool your home during the warm spring and summer
months (central air conditioning, window units, or fans and dehumidifiers), each spring you cross
your fingers that your approach still works. If not, you might be calling an expert for a tune-up,
or in extreme circumstances, you might need a complete overhaul.

Just like an AC system that has probably been dormant for many months of the year, a body
that hasn’t been physically engaged on a regular basis may have trouble getting started again.
And yet, this time of year, the warm temps draw many people to city and suburban streets,
tracks and trails, ready to take that first run of the season. A good percentage of these spring
runners haven’t kept up their strides throughout the winter. It should come as no surprise that a
4-mile run for a previously inactive person is going to stir up a few aches and pains.

Especially as we age, our ability to move undergoes changes. But whether we’re talking about a
college student or a retiree, returning to an activity without proper planning is a recipe for
disaster. That’s where physical therapy comes in. Physical therapists are trained to treat injuries
and ease pain, but they can also help their patients prevent injuries and safely prepare to
participate in new activities.

Think of physical therapists as “movement consultants” who can ensure that your body is
physically ready to tackle a new challenge—or resume a favorite leisure activity. Here’s another
example to illustrate what we’re talking about: Let’s say that you play in an adult soccer league
and you’re preparing to play in your first game of the season in a few weeks. You probably hung
up your cleats when the last season ended months ago, but expect to pick up just where you left
off. But it’s simply too much to ask for your 2019 debut on the field to be on the same level as
the last game of the previous season, when you likely had reached peak performance.

This is a good time for your PT to step in and help you shake off the rust. The rehab professional
can customize an exercise plan to help you slowly return to sport and avoid an injury that could
sideline you for the whole season. Or like cleaning the filters before firing up your air
conditioner for the first time this year, the rehab expert can help to ensure that your body is
prepared to return to its former activity level following a hiatus.

Yearly Physical Therapy Visits are Just as Important as Annual Cholesterol Tests

You know the drill: During your annual visit, your primary care physician will order a cholesterol test. Combined with an assessment of health measures such as diet and exercise, the results of the cholesterol test will provide your physician with the information she needs to make a recommendation. If the results are positive, you might hear: “You’re doing great, keep doing what you’ve been doing!” If the results are unfavorable, then you’re more likely to be told: “I’d like you to walk for 20 additional minutes each day and eat cholesterol-lowering foods like oatmeal.”

Over time, high cholesterol can cause fatty deposits to form in your arteries, putting you in a high-risk category for heart disease and stroke. Similarly, the cumulative effects of poor posture or a muscular imbalance, for example, can take a toll on your body and inhibit your ability to move properly. That’s where a physical therapist comes in: Annual PT “checkups” can catch the musculoskeletal problems that put you at risk for injury or limit your ability to function down the
line.

One of the best tools in a PT’s prevention arsenal is the movement screen. By analyzing your fundamental movements with a movement screen developed for their own practice or one that requires certification such as the Functional Movement Screen (FMS™), PTs can get a clear picture of what the future will bring for you. Based on the information gathered, a physical therapist can help you safely reach your fitness goals and teach preventive strategies that can be
incorporated into your daily life.

Of course, it’s best to schedule your checkup before you’re experiencing a problem. That way, your physical therapist can establish a baseline based on your functional level at that time and use it to identify changes during subsequent annual visits. The effects of poor posture or a muscular imbalance may not be immediately apparent to you, but they will be to your PT.

An annual “checkup” gives your PT an inside look at your musculoskeletal system, which is comprised of your muscles, bones, cartilage, tendons, ligaments, joints and other connective tissues. It’s important that these essential internal structures are working together to support, stabilize and move your body.

Just as taking an annual trek to the primary care physician helps to monitor your cholesterol levels—and prevent heart disease—yearly physical therapy appointments allow your PT to identify and address any changes in the way you move before they become something more.

Call today to set up your appointment with one of the best physical therapists in town!

One Annual Health Checkup That’s Probably Missing from Your Calendar

Some health habits are instilled in us at a young
age. For as long as you can remember, for example, you made annual treks in the family minivan to both the pediatrician and the dentist. As you entered adulthood, you probably transitioned to a primary care physician, and maybe even a different dentist better equipped to address adult needs. Anytime you’ve moved or switched insurance carriers, one of your first priorities has been to track down new providers. Now you may even choose to schedule visits more than once a year, when necessary. You
probably figure that between the two healthcare professionals, all of your health needs are covered, right?

As it turns out, these healthcare professionals aren’t specifically trained to assess your musculoskeletal system, which is comprised of your muscles, bones, cartilage, tendons, ligaments, joints and other connective tissues.
Then who is the right healthcare professional to ensure that
these essential internal structures are working properly and
helping to support, stabilize and move your body? A physical therapist.

At a yearly physical therapy “checkup,” your PT will gather your medical history and observe as you participate in screening tests and other assessments to establish a baseline of your physical abilities, fitness level and personal health. Physical therapists are educated on how your
musculoskeletal system functions properly and are trained to identify dysfunctions before they grow into bigger problems.

To maximize the encounter with your physical therapist, it’s important to be prepared before your appointment. To ensure that you cover everything and address any issues you may be having, make a list that includes:
• Health issues like diabetes or high blood pressure
• Current medications, including supplements
• Physical fitness activities
• New activities you’re considering
• Fitness goals

The information exchange between you and your PT is critical to forming an ongoing relationship, and to ensuring that you’re functioning and moving at top form. By understanding what sports and recreational activities you’re currently participating in and the fitness goals you’re aiming to achieve, your PT will be better prepared to make recommendations and tailor a home exercise program designed to help you achieve your goals.

Making wellness a part of your everyday life and taking steps to ensure that your musculoskeletal system is functioning at top notch can be very empowering
and rewarding. Why not begin—or continue—that journey with a physical therapist? Now that you know how to
prepare for a physical therapy checkup, and understand what you can expect during the appointment, the next step is us today and schedule your annual visit!

Ask a Physical Therapist To “Screen” Your Movements This Spring

Let’s talk about the last time you—or someone close to you—interviewed for a new job. Chances are that the first step was a phone screen with your potential employer, and when you passed that portion of the process with flying colors, you were then invited for an in-person interview. At that stage, the employer probably asked you to answer a series of questions and to demonstrate your skills through a test or two. The process is set up in a way that narrows down the options until the most suitable candidate is found. Makes sense, right?

Just as job recruiters screen applicants to find the best fit for
an open position, your PT will ask you to perform a series of exercises so that she can observe and understand your body
mechanics to uncover any issues or limitations. Used in combination with a full evaluation and assessment, these so-called movement screens are just one tool in identifying the most appropriate treatment or prevention program for you. But unlike that test you may have taken during a job interview, the screen is not testing your skills or abilities, it’s simply a way of identifying how your body functions during a variety of movements.

Now that spring is in full swing, it’s the perfect time of year to make an appointment with a physical therapist for a movement screen. The warmer weather means more time spent outdoors participating in sports and other recreational activities that may be physically demanding. A PT checkup that includes a movement screen will ensure that you’re physically able to engage in popular spring and summer adventures, whether it’s exploring in the woods, tending to your garden, or swimming at your family’s lake house.

Physical therapists perform movement screens for a variety of reasons, including:
• To identify areas of strength and weakness
• To uncover issues or rule them out
• To determine readiness to begin a safe exercise program
• To improve sport performance (for both novice and elite athletes)

A movement screen is something that you can have done whether you have a nagging injury or are simply ready to kick-start your activity level after a long hiatus. Gaining
an understanding of how your body performs during basic exercises such as squats and lunges helps your PT ensure that you can safely jump on a bike or into a pool this summer. And just like an employer screens candidates to identify the one individual who is likely to thrive on the job for many years to come, a movement screen can help you
develop a lasting and fulfilling relationship with the activities you enjoy most.

Call us today to schedule your FREE screening!