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.”
1
We 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.To read this article in full you will need to make a payment
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References
- 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
- Management patterns in acute low back pain: the role of physical therapy.Spine (Phila Pa 1976). 2012; 37: 775-782
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- Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.JAMA. 2015; 314: 1459-1467
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- Effectiveness and downstream healthcare utilization for patients that received early physical therapy versus usual care for low back pain: a randomized clinical trial.Spine (Phila Pa 1976). 2018; 43: 1313-1321
- Randomized controlled trials vs. observational studies: why not just live together?.BMC Anesthesiol. 2016; 16: 102
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Article info
Footnotes
Disclosures: none.
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© 2019 by the American Congress of Rehabilitation Medicine
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Access this article on ScienceDirectLinked Article
- 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.
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