美国国家公共电台 NPR Trying Physical Therapy First For Low Back Pain May Curb Use Of Opioids（在线收听）

ARI SHAPIRO, HOST:

A new study finds that when people with low back pain get physical therapy early on, they end up saving money on health care. They're also less likely to use addictive painkillers. NPR's Patti Neighmond reports.

PATTI NEIGHMOND, BYLINE: It's estimated between $80 and $100 billion are spent every year in the U.S. on treatments for back pain. Researchers wanted to see if costs could be reduced if patients did physical therapy first before moving on to other treatments. The answer, says University of Washington health care economist Bianca Frogner, is yes.

BIANCA FROGNER: The most important part for patients is that they saw a significantly lower out-of-pocket cost, on the order of almost $500 less within a year.

NEIGHMOND: Frogner headed the study, which analyzed more than 150,000 commercial health insurance claims filed between 2009 and '13. They found patients who got physical therapy first had significantly fewer imaging tests like MRIs and CT scans and fewer visits to the ER compared to patients who didn't get physical therapy. And for these physical therapy patients, Frogner also found a dramatic decrease in the likelihood of being prescribed opioids for pain.

FROGNER: We need to look for better ways to help patients manage the current pain they have and prevent it from coming back into the future.

NEIGHMOND: The study wasn't designed to look directly at how well physical therapy reduces pain. But Frogner says previous research shows it can be highly effective.

FROGNER: Physical therapists are really well-positioned to provide ideas on exercises and movements and ways of living to really prevent the pain from getting worse and hopefully from ever coming back once it's gone.

NEIGHMOND: Officials with the American Pain Society say the findings are in line with their recommendations to provide nondrug therapy, including heat, massage, acupuncture and physical therapy, as a first line of defense against pain. Pain medicine specialist Steven Stanos with the American Academy of Pain Medicine says the findings of the study offer an effective strategy to reduce patient dependence on opioids.

STEVEN STANOS: Less prescribing, potentially, would hopefully lead to less potential for harm for patients.

NEIGHMOND: One barrier to physical therapy - researcher Frogner says patients who may benefit from physical therapy often don't have access, sometimes because of health insurance restrictions or because they lack insurance, or the co-payments are just too high.

Patti Neighmond, NPR News.