753,450 eligible patients with a primary care visit for LBP between 18–60 years of age were considered.
Physical therapy was utilized by 16.3% (n = 122,723) of patients, with 24.0% (n = 17,175) of those receiving early
physical therapy that was adherent to recommendations for active treatment. Early referral to guideline adherent
physical therapy was associated with significantly lower utilization for all outcomes and 60% lower total LBP-related
costs.
Conclusions: The potential for cost savings in the MHS from early guideline adherent physical therapy may be
substantial. These results also extend the findings from similar studies in civilian settings by demonstrating an
association between early guideline adherent care and utilization and costs in a single payer health system. Future
research is necessary to examine which patients with LBP benefit early physical therapy and determine strategies
for providing early guideline adherent care.