Extended Use of Physical Medicine for Low Back Pain

At the 2023 WCRI Annual Conference, Dongchun Wang from WCRI presented a study on the extended use of physical medicine (PM) to treat low back pain.

Physical medicine includes therapeutic activities done by a physical therapist. This can range from active movement to the use of electrical stimulation. This study focused on claims involving lower back pain with accident dates from 2015 to 2019 who received PM services more than three months after the injury. This study focused on non-surgical cases.

Across the study’s 28 states, the median use of extended PM was 16%. In the highest state (New York), over 1/3 of claims in the study group received comprehensive physical medicine treatment. The study noted that the utilization of extended PM was greater in workers’ compensation than in the general population healthcare environment.

Not surprisingly, claims with extended PM had longer periods of disability and experienced significantly higher treatment costs, including the use of pain medications, epidural injections, and other non-surgical procedures.

Risk factors contributing to extended PM use included:

• Multiple medical providers
• Multiple comorbidities
• Attorney involvement
• Statistically, females had more extended PM use than males
• Statistically, office workers and low-risk occupations had more extended PM than manufacturing jobs