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Early Physical Therapy Beneficial for Acute Back Pain With Sciatica

Oswestry Disability Index score and secondary outcomes favor early PT versus usual care at four weeks

WEDNESDAY, Oct. 7, 2020 (HealthDay News) — For patients with acute back pain with sciatica, those receiving early physical therapy (EPT) have improvements in the Oswestry Disability Index (OSW) score, starting after four weeks, according to a study published online Oct. 6 in the Annals of Internal Medicine.

Julie M. Fritz, P.T., Ph.D., from the University of Utah in Salt Lake City, and colleagues conducted a randomized trial involving 220 adults aged 18 to 60 years with sciatica of less than 90 days in duration in two health care systems. Participants received imaging and medication before enrollment and were then randomly assigned to usual care (UC; one session of education) or EPT (one education session then referral for four weeks of physical therapy, including exercise and manual therapy).

The researchers found that from baseline to six months, participants in the EPT group had greater improvement for the primary outcome of the OSW score (relative difference, −5.4 points). After four weeks, the OSW score and several secondary outcomes favored EPT. Between-group differences favored EPT for the OSW score (relative difference, −4.8 points) and back pain intensity (relative difference, −1.0 points) after one year. Compared with the UC group, the EPT group was more likely to self-report treatment success after one year (45.2 versus 27.6 percent; relative risk, 1.6).

“The EPT group showed greater improvement in disability and back pain intensity across all follow-up times,” the authors write.

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