Research Sheds Light on Early Physical Therapy for Back Pain and Sciatica

Sciatica – a Pain in the Butt!

If you have had sciatica, you know how painful it can be. Sciatica is kind of a “catch-all” term used to refer to pain that refers down the leg and is caused by an irritated nerve or neural structure. Most commonly, sciatica is associated with back pain. Despite how common sciatica can be (it is more common that every joint-related leg problem COMBINED), there is not much research on how to manage it.

What We Learned

Luckily for those of us that have had sciatica, researchers just looked into this and published their results in the Annals of Internal Medicine here. In the study, patients with sciatica who reported to their primary care doctor were randomized to either “usual care” or early physical therapy. After about 4 weeks, it became clear that the physical therapy group was doing better, and at 6 months they had significantly less back pain and improved function. After a year, they were more than twice as likely to report having a successful outcome than the group that had usual care.

Back Pain Management– an Emergency?

A second study published in October 2020 in Physical Therapy Journal looked at what happened to patients who reported to the emergency department (ER) with back pain. To date, research has shown patients who consult physical therapy first generally have decreased use of opioids, unnecessary imaging, and surgery compared to those that wait or don’t go at all. The research team wanted to see if this held true for people that go to the ER with back pain, where nearly 50% continue to have pain 3 months later.

What We Learned

The study found that early physical therapy after an ER visit led to a lower likelihood of surgery, opioids, and lower costs than the group who ended up in physical therapy later. Since the groups weren’t randomized, there’s still some question about what’s happening here. However, it fits with what is now a large body of research suggesting lower costs and a faster recovery when patients see a physical therapist early on.

Take Home Message

Together, these studies should help guide YOU – the consumer – with your decision-making should you ever develop sciatica. In most states, no referral is needed to see a physical therapist. You can decide on your own to seek care from a physical therapist and improve your chances of avoiding surgery and dangerous opioids. Our physical therapists consistently rank in the top 1% nationally for effectiveness with low back pain and sciatica. Our outcomes prove it – we’ve won awards for our outcomes and we’re the only clinic in the country to publish these for all to see on our website (check out the “Outcomes” page above).