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Early referral to physical therapy improves function and other symptoms of back pain with sciatica
Starting physical therapy right away, rather than taking the usual watch and wait approach, helps to improve function and other outcomes for patients experiencing recent-onset back pain with sciatica (pain that radiates into the leg). Findings from a randomized controlled trial are published in Annals of Internal Medicine.
In the clinical trial led by researchers at the University of Utah Health, 220 adults who consulted their primary care physician for back pain with sciatica which had begun within the past 90 days were randomly assigned to either 4 weeks of physical therapy or usual care for 4 weeks. Physical therapists primarily used exercises and manual techniques such as hands-on spinal mobilization, tailoring the specifics of the treatment to individual patients. Those in the other group received no therapy but were advised to remain active and seek additional care if needed after 4 weeks. Patients reported on their level of pain and its impact on their lives—such as their ability to care for themselves and participate in social activities— after 4 weeks, then again at 6 months and 1 year.
At every point, patients who had completed physical therapy immediately after their primary care visit reported less disability than patients who took the wait-and-see approach. During the one-year study, a small percentage of participants chose to receive steroid injections or undergo surgery to treat their pain. These interventions were equally common whether or not patients received early physical therapy. The differences in outcomes between the two treatment groups were generally large enough to be considered clinically meaningful.