The Role of Physical Therapists in Managing Low Back Pain: A Collaborative Approach

by Arvie Vitente, PT, DPT, PhD, MPH, GCS, FNAP • Beth Davis, PT, DPT, MBA, FNAP • Sara North PT, DPT, PhD, M.Ed., FNAP • Margaret Wicinski, PT, DPT, EdD • Kathryn Panasci, PT, DPT, CWS

Low back pain (LBP) remains one of the most prevalent and costly musculoskeletal conditions worldwide. In celebration of World Physiotherapy Day 2024, which focuses on the theme of LBP, it’s crucial to recognize the pivotal role physical therapists play in addressing this growing epidemic. As healthcare professionals, physical therapists (PTs) have an opportunity to collaborate across disciplines in order to improve the lives of individuals affected by LBP, reduce their societal burden, and impact patient outcomes.

The Scope of the Low Back Pain Epidemic
Low back pain is one of the leading causes of disability globally, affecting people of all ages and backgrounds. The World Health Organization (WHO) highlights that up to 70% of individuals will experience LBP at some point in their lives. This condition can lead to decreased mobility, reduced quality of life, and significant absenteeism from work. Moreover, its impact on mental health, including anxiety and depression, makes it a multifaceted challenge requiring a comprehensive and interprofessional approach. LBP is also one of the most common reasons for providers to prescribe opioids, which are linked to poorer health outcomes in chronic LBP and develop into an opioid use disorder in 20% of long-term opioid users.

Physical Therapy: A Key Player in LBP Management
PTs are uniquely positioned to provide evidence-based, patient-centered care for individuals with LBP. We are trained to assess, diagnose, and manage musculoskeletal disorders through non-invasive interventions, making physical therapy a crucial first line of defense. PT interventions offer a non-opioid alternative demonstrating early evidence of success.

Key roles of PTs in managing LBP include:

• Early Assessment and Intervention: Identifying the root causes of LBP through a thorough musculoskeletal evaluation allows PTs to create personalized treatment plans. Early intervention is crucial in preventing acute LBP from becoming chronic.
• Movement and Exercise Prescription: PTs emphasize restoring mobility and function. Therapeutic exercises targeting core stability, flexibility, and strength are essential in managing LBP. Exercises are tailored to each patient’s specific needs, helping to improve functional capacity and reduce pain.
• Education and Self-Management: Empowering patients with knowledge about their condition is a key component of physical therapy. By educating patients on posture, ergonomics, and lifestyle modifications, we encourage them to actively manage their symptoms and prevent recurrence.
• Manual Therapy: Techniques such as joint mobilization, manipulation, and soft tissue therapy are often integrated into treatment plans to address specific biomechanical dysfunctions contributing to LBP.
• Collaboration with Other Healthcare Professionals: PTs work closely with other healthcare providers, including physicians, occupational therapists, mental health providers, and nurses, to create comprehensive care plans for patients with LBP. This interprofessional collaboration ensures that patients receive well-rounded care addressing both the physical and psychosocial aspects of their pain.

World Physiotherapy Day 2024: A Call to Action
World Physiotherapy’s theme for 2024, focused on LBP, highlights the need for increased awareness and effective management strategies for this condition. This year’s celebration calls on all healthcare professionals to work together in addressing this global challenge.

Here are several ways in which we can enhance interprofessional collaboration:

• Holistic Patient Care: LBP often has both physical and psychological components. By partnering with mental health professionals, PTs can provide a more holistic approach to care, addressing both the physical symptoms and the emotional distress that often accompanies chronic pain.
• Shared Decision-Making: Collaborating with primary care providers and specialists in shared decision-making empowers patients and ensures that they receive the most appropriate and effective care.
• Chronic Pain Management: For patients with chronic LBP, a multidisciplinary team approach, involving physical therapists, pain specialists, and occupational therapists, can significantly improve outcomes by addressing functional limitations and reducing reliance on medications such as opioids.

Looking Ahead: Building a Collaborative Future
As we celebrate World PT Day 2024, it is essential to recognize that the PT's role in managing LBP extends beyond the clinic. The physical therapy profession stands at the forefront of a global effort to address this pervasive condition. However, it is through interprofessional collaboration that we can truly make a lasting impact.

By fostering teamwork among PTs, physicians, nurses, occupational therapists, and other healthcare providers, we can improve patient outcomes, reduce the burden of LBP on society, and enhance the quality of life for millions of individuals. Together, we can take a proactive approach to tackle this epidemic head-on.

In the spirit of World PT Day, let us continue to work together to champion collaborative care for LBP and create a brighter, pain-free future for all.