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More workers with lower back pain are receiving physical therapy to treat their workplace injuries, and that therapy is leading to shorter durations of disability and lower medical costs, according to a study released Tuesday by the Workers Compensation Research Institute.
Researchers at Cambridge, Massachusetts-based WCRI examined 26,000 low-back workers comp claims with more than seven days of lost time in 27 states between Oct. 1, 2015, and March 31, 2017. The study found that medical costs for workers with low-back pain who started physical therapy within three days of injury were nearly a quarter lower than for workers who didn’t begin physical therapy for more than 30 days after their injury.
Researchers found that workers who initiated physical therapy more than 30 days after their injury had a 58% longer duration of temporary disability than those who started therapy within three days. Workers who didn’t receive PT for more than 30 days after their injury were also 46% more likely to receive an opioid, 47% more likely to receive an MRI, 29% more likely to receive pain management injections and 89% more likely to have low-back surgery than those who had PT within three days. However, fewer than 15% of low-back pain claimants received injections and fewer than 5% had back surgery.
The study also found that attorney involvement in claims was 27% for workers who didn’t receive PT for more than 30 days postinjury compared with an average of 14% for those who received PT early.
Although the study found a strong link between early PT and lower medical costs and shorter disability duration, the researchers noted that “association is not causation” and that other factors, such as injury severity, comorbidities, timing to first medical visit and worker behaviors could also influence the timing of physical therapy and the workers’ outcomes.
Excessive use of physical therapy can be a significant cost driver for workers compensation payers and can impede return to work, according to a recent study.