Tallahassee, Florida, October 20, 2008 – Neck pain is one of the top 10 reasons for a patient to visit a doctor. The lead article in the most recent issue Spine reports on the results of a randomized clinical trial which demonstrated that patients who received manual physical therapy and exercise had twice the improvement in symptoms compared to the current guideline group. The subjects in the study experienced both short and long term improvements in their neck pain. The study compared the use of manual therapy and exercise compared to the current guidelines of advice, rest, and range of motion. The results of this study are comparable to those reported by Hoving et al in 2002, which also demonstrated that manual physical therapy and exercise resulted in excellent clinical results in the treatment of neck pain while also providing a significant cost savings compared to usual physician care (Kothals-de Bos et al 2003). Manual physical therapy includes the use of hands-on techniques including joint and soft-tissue mobilization, designed to restore motion and reduce pain. Hurwitz et al (2008) concluded in a systematic review on neck pain also in the journal Spine, “Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain.”

Tim Flynn, PT, PhD, president of the American Academy of Orthopaedic Manual Physical Therapy, expressed confidence that, “This study broadens the base and depth of evidence that manual physical therapy is the first line treatment for patients suffering from neck and arm pain.” He continued, “Year after year the physical therapy profession continues to produce high quality randomized, controlled trials that demonstrate conclusively that our profession provides better outcomes for less money, while also being substantially safer than other medical interventions. Wake up America, to a new day without pain.” If you have neck or back pain or the aches and pains of musculoskeletal problems contact your local physical therapist today.

Physical Therapy an Alternative to the High Risks of Methadone

Tallahassee, Florida, August 18, 2008 – A recent investigative report1 published in the New York Times highlights the alarming increase in methadone prescriptions for the treatment of chronic spinal pain.  The result has been a shocking increase in methadone related deaths.  Physical therapists can play a role in providing patients and physicians with an alternative to dangerous pain medications like oxycodone and methadone.

Methadone was once limited to use in addiction treatment centers to replace heroin, but today it is frequently given out by physicians to manage spine and joint pain.  The Drug Enforcement Administration noted that from 1998 to 2006, the number of methadone prescriptions increased by 700 percent.  “Many legitimate patients, following the direction of their doctor, have run into trouble with methadone, including death,” noted pain specialist Dr. Howard A. Heit from Georgetown University.  Florida alone, which keeps detailed data, listed methadone as a cause in 785 deaths in 2007, up from 367 in 2003.

“These are senseless deaths,” said Dr. Timothy Flynn of Regis University in Denver, CO, and President of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT).  “Patients should be aware that these medications are not the best option to reduce the symptoms of spinal pain. Research has shown that early movement and treatments like exercise and spinal manipulation offer strong benefits to spine pain and disability.”  “The medical management of spinal pain in this country is a failure,” continued Flynn, “we too often initiate prescription drug therapy before choosing safe and effective alternatives.”  Flynn suggests that patients seek out physical therapists as a first-line treatment for these conditions.

A February 2008 report published in the Journal of the American Medical Association reports that from 1997 to 2005, pharmaceutical expenditures for the management of low back pain increased by 171% while the rate of good outcomes fell.  “All the imaging we do, all the drug treatments, all the injections, all the operations have some benefit for some patients,” said Richard A. Deyo, a physician at Oregon Health & Science University in Portland and a coauthor of the report.  “But I think in each of those situations we’ve begun using those tests or treatments more widely than science would really support.”

For more on the benefits physical therapists can provide in the management of spinal pain, contact your nearest physical therapist or visit the American Academy of Orthopaedic Manual Physical Therapists website at www.aaompt.org.  AAOMPT represents physical therapists by promoting excellence in orthopaedic manual physical therapy practice, education and research. 

Dr. Richard Deyo, MD, MPH will be the key note speaker at AAOMPT’s Annual Conference in Seattle this November.  The conference theme will focus on pain management and physical therapists’ role in this important area of care.

BENEFITS OF SPINAL SURGERY DISAPPEAR AFTER 6 MONTHS
Physical Therapy offers same outcomes for patients with sciatica 6 months after surgery!

Tallahassee, Florida, June 23, 2008 – A recent study published in the British Medical Journal1 reports that spinal surgery for patients with sciatica offers a short term benefit, but by 6 months that benefit disappears and no difference is seen between patients who had surgery and those receiving physical therapy.  The study suggests that the benefits of surgery are only short-term and conservative treatments such as physical therapy may offer the same outcome.
Sciatica often resolves quickly, but in some patients it persists.  Previous to this study, only limited evidence existed that could guide patients about when or if that resolution was going to occur.  In this study, patients had the option of opting for early surgery, or prolonged conservative management under the guidance of a physical therapist.  The surgical group showed improvement in symptoms for only a brief period following surgery.  But, by 6 months, and up to 2 years following surgery, the difference between the groups having surgery and those that didn’t disappeared. 
“The significance of this study is that patients may be able to avoid surgery if they realized they can expect a similar improvement in symptoms if they use other ways to manage the pain for 6 months,” said Dr. Timothy Flynn of Regis University in Denver, CO, and President of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT).  “Patients should be aware that surgery is not the only option to reduce the symptoms of sciatica.”
The study’s authors conclude that since the early benefits of surgery are gone by 6 months, when deciding to have surgery for sciatica, well informed patients, and not physicians, should decide if and when they opt for surgery. 
The results of this study, coupled with the findings of another study published earlier this year suggest expensive treatments for low back pain may not be the best approach.   Less expensive conservative options like physical therapy may be the preferred choice for patients with low back pain.
“The best course of treatment for low back pain is to make sure it is addressed early and does not progress to leg pain, or become a chronic condition,” continued Flynn.  “Research has shown that early movement and treatments like exercise and spinal manipulation offer strong benefits to this group of patients.”
These treatments include hands-on physical therapy to mobilize the spine and exercises designed to alleviate low back pain.  Flynn suggests that patients seek out physical therapists as a first-line treatment for these conditions.

 Spinal Manipulation, Exercise and Advice Offer Patients an Effective Alternative for Back Pain

 Tallahassee, Florida, Feb. 14, 2008 – Health care expenditures for patients with spinal conditions are rising without an associated increase in health status, according to a February, 2008 research report appearing in the Journal of the American Medical Association. The study suggests Americans may be wasting their money for treatments as the overall proportion of people with impaired function increased from 1997-2005, despite a 65% increase in expenditures to treat spine conditions. Physical therapists offering spinal manipulation, exercise, and advice can provide an effective alternative for patients with back and neck problems, often at a lower cost.

“I think the truth is we have perhaps oversold what we have to offer,” said Richard A. Deyo, a physician at Oregon Health & Science University in Portland and a coauthor of the report. “All the imaging we do, all the drug treatments, all the injections, all the operations have some benefit for some patients. But I think in each of those situations we’ve begun using those tests or treatments more widely than science would really support.”

What science does support is the effectiveness of physical therapy for affecting outcomes in patients with spinal conditions. “Research has consistently shown the value of particular physical therapy interventions for patients with back and neck problems,” said Dr. Timothy Flynn of Regis University in Denver, CO, and President of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT). “Specifically, spinal manipulation and exercise have repeatedly been shown to be effective in managing patients’ current pain and preventing future episodes.” Particularly discouraging in this recent report was an increase in pharmaceutical expenditures of 171% during the study period. This suggests that physicians are over-utilizing an ineffective treatment for spine pain. “You have drugs, you have surgery, or you have us,” explained Flynn. “The reality is that very few treatments have shown the ability to truly affect patients with spine conditions. Physical therapists can do just that.” These treatments include hands-on therapies to mobilize the spine and exercises designed to alleviate low back pain. Flynn suggests that patients should seek out physical therapists as a first-line treatment for these conditions. A separate study in 2006 demonstrated that patients with back pain were experiencing an increase in the rates of imaging and injections, meanwhile realizing a significant under-utilization of physical therapy.

For more on the benefits physical therapists can provide in the management of back and neck problems, contact your nearest physical therapist or visit the American Academy of Orthopaedic Manual Physical Therapists website at www.aaompt.org. AAOMPT represents physical therapists by promoting excellence in orthopaedic manual physical therapy practice, education and research.