We would like to thank the authors of the Letter to the Editor for their interest and insight into our review, “The Impact of Timing of Physical Therapy for Acute Low Back Pain on Health Services Utilization.”
1We agree that to make more definitive causal claims about the outcomes from the timing of physical therapy, randomized control trials (RCTs) are needed. The final version of the abstract will reflect a modification that removes causal claims. We believe that future research in this area should focus on using rigorous methodological designs that include randomization and observational studies that use large databases of medical records, claims, and representative national samples. Both of these designs or approaches provide valuable information on how timing of care affects pain-related outcomes.
- Arnold E.
- La Barrie J.
- DaSilva L.
- Patti M.
- Goode A.
- Clewley D.
The impact of timing of physical therapy for acute low back pain on health services utilization: a systematic review.
Arch Phys Med Rehabil. 2019; 100: 1324-1338
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- The impact of timing of physical therapy for acute low back pain on health services utilization: a systematic review.Arch Phys Med Rehabil. 2019; 100: 1324-1338
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© 2019 by the American Congress of Rehabilitation Medicine
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- Early Physical Therapy for Acute Low Back Pain May Not Reduce Health Services Utilization, Costs, and Opioid UseArchives of Physical Medicine and RehabilitationVol. 100Issue 7
- PreviewWe read with interest the article published by Arnold et al1 examining the effect of timing of physical therapy (PT) for acute low back pain on health services utilization (HSU). Reducing overuse of imaging, opioids, injections, and surgery for low back pain is an international priority.2 That early access to PT could replace or reduce many of these services is not an unreasonable proposition, and one that is worthy of rigorous scientific investigation. However, we feel that by emphasizing observational studies over randomized controlled trials in their synthesis of available literature, the authors have, in this case, taken an approach that was suboptimal.