In prior blogs, I’ve talked about the value of having a good physical therapist on your health care team. I’d now like to be specific about the actual costs and benefits of having musculoskeletal physical therapy compared to other common treatments.
Musculoskeletal Pain or Disorder
Musculoskeletal pain or disorder is an injury to the bones, muscles, ligaments, tendons, spinal discs, fascia or other soft tissue. Musculoskeletal disorders are extremely common and very costly. According to the Centers for Disease Control:
- Musculoskeletal disorders are the most common reason people over the age of 50 become disabled (reduced quality of life).
- Musculoskeletal pain is the most common reason people over 50 go to the doctor aside from the common cold.
- Musculoskeletal disorders are the single largest category of on-the-job injuries.
- Musculoskeletal disorders cost U.S. companies $50 billion annually in direct medical costs.
- A single musculoskeletal injury costs on average about $15,000 – a portion of which will be paid by the injured person (you!)
We know musculoskeletal pain is an extremely common problem that costs a lot of money, time and frankly, annoyance. If you have not experienced it yet, you will and the odds increase the older you get. Thankfully, these injuries are highly preventable and treatable with musculoskeletal physical therapy. So, the question becomes, what kind of treatment is most effective for musculoskeletal pain in terms of cost, benefits and time for recovery?
Musculoskeletal Physical Therapy
By far, the largest body of research supports musculoskeletal physical therapy as the number one treatment for musculoskeletal pain. We measure success in physical therapy in two ways: You get relief of some or all the pain and you improve your overall function (i.e. you can walk further, climb stairs easier, return to sport, etc.) After a good round of physical therapy, you should see improvements in pain and function.
Good musculoskeletal physical therapy should include:
- A physical therapist who is skilled in hands-on assessment and treatment (manual therapy)
- One-on-one visits with your physical therapist rather than being largely unsupervised or having multiple providers
- A comprehensive home program that you do regularly that includes exercise, posture changes, activity modification and progressive return to sport/activity
The goal at the end of a good round of musculoskeletal physical therapy treatment is that you, the patient, understand your injury, how to manage it moving forward, and when to call your physical therapist if the pain or injury flares up again. If you are not getting care as listed above and/or are not seeing changes in pain and function, then call Life’s Work Physical Therapy. Physical therapy costs range between $120-$280 per visit depending on visit length, and is covered partially or fully by most insurance plans.
One final note, physical therapy only works when you, the patient, do the work at home and take ownership of the problem. Though musculoskeletal physical therapists are very good, we are not magical. We can’t spend 1-2 hours per week with you and magically fix the problem. You must manage your body the other 166 hours each week with the prescribed physical therapy program! When you do the work, you will get better.
Other Common Treatments for Musculoskeletal Problems
Below are some other common treatments for musculoskeletal problems. Treatments that reduce pain but offer no long-term solutions in terms of how to make your body work better are typically short-lived. The most common treatments are pain medications, cortisone or other injections, and surgery. Surgery is typically done after conservative measures have failed, but in some cases, is the first option for treatment.
Pain medications affect the central nervous system to block your ability to feel the pain. While pain relief is possible, these medications do nothing to help you heal from the injury. In addition, the risk of dependence and overdose are substantial with more people dying every year from an overdose of prescription pain medications than from heroin and cocaine combined. The actual cost to you can be small, ranging from $8 to $143 for a 120-day supply depending on the medication. Again, the issue to remember is that this only blocks pain, it does not help you recover from injury. The research indicates it is a poor long term choice for the treatment of musculoskeletal pain.
Injections can be used to treat musculoskeletal pain. Cortisone injections are one of the most common, and can be injected into soft tissue, joints and the spine. Cortisone is an anti-inflammatory medication that can produce pain relief lasting several days to a few months. The Mayo Clinic recommends no more than 3-4 cortisone injections per year due to its side effects. Cortisone injections range widely in price ($120 to $400) depending on the body area, whether it’s image-guided, and if office visit costs are included. Hyaluronic acid injections have become popular for knee osteoarthritis in the last few years. According to the September 2016 issue of the Journal of Bone and Joint Surgery, HA injections cost about $1,128 per patient and have mixed results for pain relief on patients with knee osteoarthritis. Your insurance plan may cover part, all or none of these costs depending upon your plan. Relief is short-term.
Surgery is another common treatment for musculoskeletal pain. Many times, surgery is the best line of defense for injuries such as ACL tears, fractures or end stage arthritis. In some cases, however, musculoskeletal physical therapy is a more effective, less risky option. Surgery is inherently risky – 1 in 8 people have a post-operative infection and an increased chance of death. Many spinal surgeries have a very high re-operation rate. Lumbar fusions have a 1 in 4 chance of needing another surgery, and simple lumbar surgeries have a 1 in 5 chance of needing another surgery. Because surgery requires so many resources, it is very costly. Most patients must pay a portion.
Menisectomy is a $4 billion per year industry in the United States, and many research studies have shown that it’s not more effective than musculoskeletal physical therapy in terms of outcomes. Spinal surgery is staggering in terms of costs, ranging from $26,000 to $81,000 depending on the complexity. Again, the research indicates that physical therapy can be as effective as surgery in reducing most types of spine pain.
In summary, there are many options for treatment of musculoskeletal pain. Whatever you choose, be informed and take an active approach to managing your body. The evidence and research is clear that musculoskeletal physical therapy is the most effective long-term option for musculoskeletal injuries. When I hear patient say they don’t have time or money to invest in physical therapy, I always think about all the time and money that gets wasted being injured or chasing a short-term fix. There is no magical panacea.
If you want resolution to your pain, call a Life’s Work Physical Therapist today. We will build a plan for you and get you back to life!