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Seeing physical therapists early for neck pain is better than waiting


New strategies are needed to improve healthcare system


Under the current system, the majority of healthcare in the U.S. is delivered in a fee for service, volume-based model. This means that healthcare providers like doctors have an incentive to handle a large number of patients since they will receive payment for their services regardless of each patient's outcome. Using this type of system is one of the main reasons that healthcare costs continue to increase in the country. Clearly, new strategies are needed to improve the system so that patients can receive the best and most appropriate care possible at a reasonable cost. One way to do this is by identifying treatments that are effective for the patient, priced reasonably and given at the appropriate time. The use of physical therapy early on is one treatment that is studied in this regard.


The benefits of early treatment for neck pain have not been studied


Recent studies have shown that early physical therapy for lower back pain is recommended to improve the outcomes of patients better than prescription medications and other treatments. It has also been found associated with less use of healthcare resources and lower costs overall. Neck pain is the second most common disorder that affects the body's movements behind lower back pain, and physical therapy is commonly used to treat it; however, the effects of early physical therapy for neck pain have not been studied. For this reason, a study was conducted that compared patients with neck pain who received physical therapy at an earlier date with those that waiting a period of time before beginning physical therapy.


Information from a large database used to compare both patient groups


A large database with detailed information about patients who received physical therapy for neck pain was used to conduct the comparison of early and delayed users. Patients were categorized as using early physical therapy if they reported their pain in less than four weeks, while those who waited longer than four weeks were classified as delaying physical therapy. A total of 1,531 patients were identified from the database and fit the necessary criteria. This included 451 patients who received early physical therapy and 1,080 who received delayed physical therapy.


Early physical therapy leads to several benefits over delaying


After comparing both groups of patients, it was found that those who received early physical therapy experienced better outcomes with less disability and pain than those who delayed it. This was found to be the case not only in their actual outcomes but in their value as well since patients got more out of each dollar they spent with early physical therapy over delayed physical therapy. Since patients improved more and required less treatment, there was also a benefit in cost for the physical therapists and insurance companies. Finally, the overall efficiency of treatment was found to be superior in the group that received early rather than delayed physical therapy. These findings clearly show that seeing a physical therapist for neck pain within four weeks will lead to much better outcomes than waiting longer to do so. More research is needed to confirm these findings and eventually make policy changes to reflect them, but in the meantime, patients who have neck pain are encouraged to see a physical therapist early instead of delaying treatment in order to experience the best possible benefits.


-As reported in the July '16 issue of BMC Health Services Research
September 28, 2017