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For years the medical model for treatment of musculoskeletal pain, including low back pain, included a period of “wait and see” to monitor symptoms prior to the initiation of physical therapy rehabilitation. A recent study published in Spine indicates that this may no longer be the most appropriate practice, and in fact, may lengthen injury time and lead to an increase in health care costs to insurance providers.

Researchers examined over 32,000 patients who saw their primary care physician for low back pain. Those who were referred to physical therapy early, within 14 days, required less health care utilization and experienced lower health care costs than those whose referral to physical therapy was delayed (15 – 90 days after consultation with PCP). Early physical therapy referral was also associated with decreased risk of surgery, decreased use of injections, less physician visits, less use of pain medications and less advanced imaging, such as MRIs or CT Scans. Average health care costs for those receiving early physical therapy treatments were more than $2,500 lower.

Historically, primary care guidelines recommended delaying physical therapy referral for several weeks. However, lead author, Julie Fritz, PT, PhD, ATC, notes “half of the patients receiving treatment from a physical therapist did so within two weeks, which is a practice that may be justified by emerging evidence.” Fritz also reports that physical therapists often promote a greater sense of self-reliance in managing low back pain which is strongly linked to a positive outcome. These positive management strategies that foster self-efficacy appear to be an alternative to passive strategies such as medications and additional imaging.

This evidence can likely be extrapolated to musculoskeletal injuries and pain in other parts of the body. As a result, consult your physician about an early entry into physical therapy as opposed to the “wait and see” method.