According to a study issued in 'Archives of Physical Medicine and Rehabilitation', the early physical therapy (PT) for acute low back pain (LBP) decreases the health services utilisation (HSU) and cost, reduces opioid use, and may improve the healthcare efficiency.

Elizabeth Arnold et al. studied the impact of early PT for acute LBP on subsequent HSU, as distinguished from delayed PT or usual care. The data sources comprised of Electronic database search of MEDLINE, CINAHL, and EMBASE from their inception to May 2018. The results from prospective, retrospective cohort studies and RCTs that examined the relationship between early PT and HSU were compared to the delayed PT or usual care.

For inclusion of the studies as per the eligibility criteria, two authors screened the titles, abstracts, and full-text articles, whose discrepancies were further resolved by a third author. Out of 1,146 articles, 11 articles were included in this systematic review where the data were extracted by two independent reviewers on the basis of the participant population, PT timing, comparison to delayed PT or usual care, and downstream HSU. Moreover, a third reviewer examined the information to assure the correctness and consensus of information. The Downs and Black checklist was used to assess the risk of bias using the same method.
Early PT is before completion of 30 days from the index visit for acute LBP. In five out of six studies it was noted that the early PT reduces the future HSU cost when compared to the delayed PT. Also, the random-effects meta-analysis showed a notable decrease in opioid use, spine injection and surgery. Mixed results were observed in five studies which compared early PT to usual care.

This review may be beneficial for the patients, healthcare providers, healthcare systems, and 3rd party payers in making decisions for acute LBP treatment.