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See a physical therapist first for lower back pain
Movement is Medicine

See a physical therapist first for lower back pain

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Fact: 80 percent of people will experience back pain in their lifetime. Yes, you read that correctly, 80 percent. Here are some more facts: Back pain is the second most common neurological ailment in the U.S. and back pain is the most common job-related disability. Due to the numbers of people experiencing low back pain, I am sure you can guess that the cost for treating low back pain must be high. In fact, in 2004 the estimated cost of treatment of low back pain was $193.9 billion. If we spent that much in 2004, imagine what we are spending today.

So what if I told you there is a way to recover from your back pain and save money at the same time?

Go to physical therapy first.

The research supporting going to physical therapy first is growing.

A Texas study shows patients benefit from direct access to physical therapy.

Here are some additional studies available at “Move Forward. Physical Therapy Brings Motion to Life” ( that support early referral to physical therapy.

  • Education from a physical therapist before back surgery may reduce your cost and improve outcome (August 2014)
  • Beginning Low Back Pain Treatment With Advanced Imaging Leads to Higher Total Costs (March 2015)
  • Early Physical Therapy can Be Cost Effective Treatment for Low Back Pain (April 2013)
  • Back Pain is Often Over-treated (Sept 2013)
  • Physical Therapy as Effective as Surgery for Degenerative Disk Disease (Sept 2013)
  • Physical Therapy Equal to Surgery for Spinal Stenosis (April 2015)

As the evidence builds, it is important that you become your own best advocate. If you have back pain, get into see your physical therapist (PT) for an evaluation. Your PT will review your health history, discuss your specific symptoms and most importantly rule out any major red flag symptoms. Then they will move onto to looking at your posture, muscle flexibility, joint mobility and muscle strength to design a specific program to address your issues. Don’t forget that in California you can go directly to your PT for an evaluation without seeing a physician first.

Keep up with the growing evidence, skip the prescriptions and think PT first for low back pain.

Maria Fermoile is a Doctor of Physical Therapy at Alliance Rehabilitation in Fresno. She alternates writing this column with Dr. Chris Telesmanic. Both will be happy to answer questions submitted to or Learn more about movement, fitness and health in this space each week, or by going to, or calling 478-5833.

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