My Back Hurts, What Should I Do?

Back pain is the most common pain seen in outpatient physical therapy clinics across the country, with data showing that low back pain accounts for 50 percent of all patients seeking outpatient physical therapy care.¹ What’s more, one quarter of adults in the U.S. have reported back pain at least one day in the past three months.¹

From a physical therapist standpoint, we are always trying to find the optimal ways to treat low back pain because it is so prevalent. Read below to learn what you should do if you are experiencing back pain.

Do I need to see my doctor before going to physical therapy?

Many people think they need to see their doctor prior to going to a physical therapist. However, many states have direct access laws that allow patients to see a physical therapist without a prescription.* By going to a physical therapist first, you can start treatment sooner. This can expedite the recovery process so you can get back to doing the things you love.

To learn more about direct access, read our “Physical Therapy without a Prescription? Your Questions Answered” blog.

*To learn about direct access laws in your state, please call an Athletico clinic near you.

What about getting imaging tests before starting physical therapy?

Many people see their doctor first for back pain so that imaging (x-ray or MRI) can be performed before treatment is started. The rate of lumbar spine imaging in the U.S. is growing very rapidly and there is little evidence to support that imaging improves a patient’s results over the course of treatment.¹ Most imaging of the lumbar spine will show something, which could be benign findings like mild arthritis or degenerative disc disease, or a more severe diagnosis. It is important to note that these diagnoses do NOT correlate to pain. In fact, some of these terms can be detrimental to your outlook and your perceived health of your back and lead to a more chronic condition.¹

While imaging is not required before seeing a physical therapist, your therapist may recommend imaging tests if they feel it is appropriate. For instance, if you try physical therapy and there isn’t an improvement in your symptoms, your therapist may refer you to a doctor for imaging at that time.

There are also some situations where imaging is recommended prior to physical therapy. For example, imaging is important for patients with low back pain who are also showing neurological symptoms such as changes in bowel or bladder, progressive motor weakness, numbness or tingling in a radicular pattern (down the arms or legs). Likewise, if the injury was due to a large trauma, imaging will check for fractures that may have occurred.

Why choose physical therapy as a first treatment option for back pain?

By trying physical therapy as a first treatment option for back pain, you may be able to avoid unnecessary medication, surgery or extensive imaging tests, including X-Rays, MRIs and CT scans. What’s more, studies have found that patients who begin physical therapy within the first 14 days of pain save an average of $2,700 over the course of their treatment.²

One of the best things you can do is see your physical therapist soon after injury. There is evidence that certain therapy techniques are more beneficial within a short time frame after injury. Generally speaking, you don’t need to run to your therapist with every small ache or pain. However, if you are having daily back pain that is not getting better, it is a good idea to see a physical therapist rather than waiting weeks or months to address the issue.

If you have back pain, click the link below to request a free assessment at a nearby Athletico clinic.

Free assessments are available both in-clinic and virtually through our telehealth platform.

Request a Free Assessment

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

References:
1. Flynn TW, Smith B, Chou R. Appropriate use of diagnostic imaging in low back pain: a reminder that unnecessary imaging may do as much harm as good. J Orthop Sports Phys Ther. 2011;41(11):838-46.
2. Fritz, Julie M., et al. “Primary Care Referral of Patients With Low Back Pain to Physical Therapy.” Spine, vol. 37, no. 25, 2012, pp. 2114–2121., doi:10.1097/brs.0b013e31825d32f5.