Although patients with LBP are commonly referred to physical therapy, the referral is often delayed. A number of studies have shown that early access to physical therapy (within 30 days) by patients with LBP actually improved patient outcomes. Early access was associated with decreased utilization of advanced imaging, decreased additional physician visits, and fewer surgeries, injections and opioid medications.16-20
After information is gathered from self-reported measures, the history and a thorough physical examination, patients are allocated into one of four subgroups: manipulation, stabilization, specific exercise (flexion, extension and lateral-shift patterns) and traction. Each subgroup is named for the primary treatment that the patients would receive once assigned.
TBC Category 1: Manual Therapy Subgroup
This subgroup is believed to respond favorably to manipulation and/or mobilization of the lumbar spine or sacroiliac joint. Evidence suggests that patients who fall into this subgroup generally have a shorter duration of symptoms (<16 days), at least one level of hypomobility (segmental stiffness) of the lumbar spine and symptoms that don’t extend beyond the knee.21