Low back pain (LBP) is one of the leading causes of pain in the U.S., and in the military, it's a common reason for absenteeism and long-term disability. Traditionally, LBP in the military has been treated by family practice physicians, who occasionally refer patients to physical therapists; however, this process has been identified as more expensive than allowing patients to directly access physical therapy. In addition, there is sufficient evidence that supports the many benefits of early access to a physical therapist in general, but evidence is lacking to confirm this in the military. Therefore, a study was conducted that compared the management strategies of patients and family practitioners for patients with LBP.
Over 500 physical therapists and family practice physicians currently practicing in the U.S. Air Force were invited to participate in the study. Of these, 54 physical therapists and 130 physicians responded and agreed to participate. Data was collected on these medical professionals by using two examinations designed to assess their knowledge, attitudes, the usefulness of clinical practice guidelines, and management strategies for patients with LBP. Results from these examinations were then compared to detect any significant differences.
Overall, though physical therapists and physicians reported similar results in certain categories, there were a number of important differences between them. On the first examination, physical therapists were found to be more likely to have no difficulty assessing the motivation level of patients with LBP than physicians. According to the other, physical therapists were more likely than physicians to recommend the proper drug treatments for LBP patients and to believe that patient encouragement and engagement is “extremely important” in order for them to improve. These results suggest that on the whole, physical therapists showed improved knowledge of optimal management strategies for LBP than physicians. Part of this can be explained by the one-on-one nature and greater length of physical therapy visits. Patients with LBP should therefore strongly consider direct access to physical therapy for more immediate, more effective and less expensive care from a professional that's more knowledgeable on the condition.
-As reported in the February '14 edition of Military Medicine