Physical Therapist Assessed Initial Lower Back Pain: A Retrospective Cohort Study.

Treatment of patients with low back pain (LBP) amenable to improvement through physical therapy usually follows one of two pathways. The first is primary-care provider and nursing evaluation, often with imaging, pain medication, and a frequently delayed physical therapy referral. The second is a multi-disciplinary approach of embedding a physical therapist to assist with evaluations and active physical therapy treatment as early as possible. The present study compares the results of the first instance of LBP for the traditional pathway to the early physical therapy pathway for patients of the U.S. Department of Veterans Affairs hospital in Sioux Falls, South Dakota. The research comprised a retrospective review of electronic records of patients presenting the first onset of LBP evaluated in primary care. The patients on the first pathway had nursing and primary care providers assess patients during the initial visit and later referred them to outpatient physical therapy. Patients on the second pathway had a physical therapist on the primary care team. The results of this study show that second-pathway patients required fewer images, specialists, sessions, and pain medications; they had fewer no-shows at follow-up appointments.