Low Back Pain is one of the most common and disabling injuries. It is known to affect 60-70% of adults during their lifetime, and up to 5% of adults each year. It leads to over 149 million days of missed work in the United States each year and leads to health care costs of 100 to 200 billion dollars per year. The frequency and costs of LBP makes it one of the top 10 most burdensome diseases and injuries as defined by the World Health Organization.

Even though it is quite common, Low Back Pain continues to be poorly understood. There is not one specific known cause for LBP. We know that obesity, age, and occupational postures play a role in causing low back pain. However, no one specific cause can be identified. Beyond this, X Rays and MRIs of the low back are often misleading. They can show findings (such as “degeneration”) that can be unrelated to the pain that someone is experiencing. MRIs of healthy individuals with no back pain can show spine degeneration that is similar to people with low back pain. This makes it a challenge for some health care providers to identify and treat low back pain.

However, a physical therapist is uniquely skilled to provide treatment for low back pain. Physical therapists provide known methods of improving low back pain. These include exercise, hands on treatment, and a progressive return to daily activities. Research studies show that Physical Therapists are also skilled at guiding patients through an episode of low back pain, providing assurance that things will improve and progressing exercises in a way so as not to increase symptoms. These treatments, while seemingly simple, are shown to be the best treatment for low back pain according to medical research.

Physical therapists are also positioned to treat the spine effectively because they utilize treatment-based classification. Treatment based classification means that therapists group patients based on symptoms that are known to respond to specific treatments. An example of this is that patients with low back pain who have no pain spreading below the knee and pain duration of less than 16 days typically respond favorably to hands on manipulation of the spine. Similar treatment-based classifications are available for direction specific exercises, core stabilization, and traction of the spine. Treating patients based on clusters of symptoms allows therapists to bypass the difficult and unreliable method of diagnosing specific spine injuries. Additionally, they do not have to rely on MRIs or X Rays, which can be misleading and costly. Instead, they provide treatments that are matched to the person’s symptoms.

Research also shows that the time a patient waits to receive treatment is critical to recovery. Patients receiving PT within 2 weeks from the start of low back pain have better results and have a lower cost of care. In Wisconsin, you can see a physical therapist without a referral. This is called Direct Access, and it allows patients to access the care they need immediately without waiting for a physician’s approval. Direct Access can get patients to the correct provider in less time. Direct Access improves outcomes and decreases cost of care to the consumer.

When a patient is referred to PT, the average time for a patient with low back pain to receive care is 60-75 days. This is a major barrier to patients receiving the best results possible. By going to a PT directly, a patient can avoid the wait and get results faster. Early access to care also leads to less use of surgery, injections, imaging and opiate medication use. Direct Access is legal throughout the State of Wisconsin and is provided by more than 50% of Physical Therapists. Determining availability of these services is as easy as calling your preferred Physical Therapy location.

To summarize, people with low back pain achieve the best outcomes at a decreased cost when seeing a Physical Therapist within 14 days of onset. See your physical therapist today! Neal Scibelli, PT, DPT Board-certified Orthopedic Clinical Specialist Board-certified Sports Clinical Specialist Neal Scibelli is the Spine Coordinator of Rehab Services for Aurora Health Care’s Greater Milwaukee North and South Regions. He promotes best practice in Spine Care throughout this region, emphasizing a patient first approach, with best outcomes at the lowest cost a priority.



  1. Steve's Gravatar

    Physical Therapy Service

    Steve | February 11, 2020 at 3:25 AM

    Thank you for this information, I appreciate your effort, please keep us update.


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