Does Physical Therapy Timing Make a Difference in Treating Back Pain?
Current guidelines recommend delaying referrals for physical therapy, in part because previous research found that early aggressive therapy contributed to higher health care costs and did not seem to make significant improvements for patients.
Current guidelines recommend delaying referrals for physical therapy, in part because previous research found that early aggressive therapy contributed to higher health care costs and did not seem to make significant improvements for patients. A recentJAMAstudy adds to that body of evidence, as it found that early physical therapy for low back pain seems to make only modest improvements that do not lead to significant differences compared with usual care.
Researchers from the University of Utah in Salt Lake City recruited and randomized 220 patients with low back pain into 2 treatment groups to determine the effect that early physical therapy has on improving disability. The 18-to-60-year-old study participants had no back pain within the previous 6 months, an Oswestry Disability Index score of at least 20, and symptom duration of less than 16 days. Each patient received education before being randomized to early physical therapy (108 patients) or usual care (112 patients). The early physical therapy group attended 4 physical therapy sessions while the usual care group received no additional interventions over the first 4 weeks of the program.
The researchers found that after 3 months, the early physical therapy group showed improvement in disability measures compared with the control group. However, the researchers noted there was no significant difference in disability between the groups at the 1-year follow-up. In addition, pain intensity did not vary at the 4-week, 3-month, or 1-year follow-up interviews between the 2 treatment groups. Any differences found between the populations were modest, the investigators said.
Knock Out Aches and Pains From Cold
October 30th 2019The symptoms associated with colds, most commonly congestion, coughing, sneezing, and sore throats, are the body's response when a virus exerts its effects on the immune system. Cold symptoms peak at about 1 to 2 days and last 7 to 10 days but can last up to 3 weeks.
COPD: Should a Clinician Treat or Refer?
October 27th 2019The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines the condition as follows: “COPD is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.â€
Diabetic Ketoacidosis Is Preventable With Proper Treatment
October 24th 2019Cancer, diabetes, and heart disease account for a large portion of the $3.3 trillion annual US health care expenditures. In fact, 90% of these expenditures are due to chronic conditions. About 23 million people in the United States have diabetes, 7 million have undiagnosed diabetes, and 83 million have prediabetes.
What Are the Latest Influenza Vaccine Recommendations?
October 21st 2019Clinicians should recommend routine yearly influenza vaccinations for everyone 6 months or older who has no contraindications for the 2019-2020 influenza season starting at the end of October, according to the Advisory Committee on Immunization Practices.
What Is the Best Way to Treat Pharyngitis?
October 18th 2019There are many different causes of throat discomfort, but patients commonly associate a sore throat with an infection and may think that they need antibiotics. This unfortunately leads to unnecessary antibiotic prescribing when clinicians do not apply evidence-based practice.
