Research has shown broadly that early PT can improve outcomes and reduce utilization of other medical services. WCRI’s new study examines how this plays out in workers’ comp cases.
Physical therapy (PT) has become a widely accepted and critical conservative care recommendation for low back pain (LBP) in the last decade, reducing the need for other, more invasive procedures and opioid prescriptions. As such, the timing of PT has become the subject of a number of studies which have proven early is better. Early treatment improves outcomes and reduces the utilization of other medical services.
Building on this research, the highly respected Workers’ Compensation Research Institute (WCRI) has conducted the most comprehensive study addressing PT timing focused on workers’ compensation patients. One of the researchers, Dr. Kathryn Mueller, is a member of MedRisk’s International Scientific Advisory Board.
Here are the study details, key findings and critical takeaways for the workers’ comp industry.
Study Details
The study looked at how different timing of PT may impact:
- The utilization of MRIs, opioid prescriptions, pain management injections, and lumbar surgeries
- Total medical costs per claim (not just PT)
- How many weeks of temporary disability benefits are used per claim
Vague terms like “early” and “late” have been interpreted any number of ways in existing research. In this study, WCRI examined the outcomes of five PT-timing groups (within 3 days, 4-7 days, 8-14, 15-30 and more than 30-days post injury) and defined “late PT” as more than 14 days of injury.
Key Findings
Patients who received early PT (within three days of injury) were:
- 46% less likely to receive opioid prescriptions
- 47% less likely to receive an MRI
- 29% less likely to receive pain management injections
- Less likely to involve an attorney in the claim (14% average involvement) than those who received late PT
Patients who received late PT (more than 30 days after injury):
- Were on temporary disability that lasted 58% longer
- Were 89% more likely to have low back surgery
- Had an average attorney involvement of 27%
It is important to note that even “late” PT can still improve outcomes over no PT at all. Across all claimants, and regardless of timing, fewer than 5% had back surgery.
Critical Takeaways
This cornerstone study clearly supports the value of including PT as a first-line treatment option and removing barriers to early PT.
While the researchers say further study is needed, the findings that early PT is “likely to be beneficially associated with a lower utilization of medical services, lower overall medical costs, and shorter temporary disability” is critical validation of the importance of physical medicine in treating injured workers.
So what can make a positive impact on workers’ comp claims? Experience shows that rapid scheduling, patient advocacy, clinical guidance that supports conservative care first, integrated technology, and a management program that connects patients with the right PT quickly have a significant impact on outcomes and cost.
