In our Boulder Physical Therapy practice we aim to help accelerate a patient’s recovery by optimizing outcomes in fewer visits.  Consistent with the medical evidence, manual therapy in our practice rapidly reduces a patient’s pain allowing them to resume normal activities and exercise often in 1-2 visits.  As clinicians, we know this rapid improvement is important not only because it positively impacts a patient’s symptoms but also because it strengths the clinician’s reasoning process on the appropriateness of a given treatment intervention.  Previous research has highlighted the importance of these early changes and a new article sheds light on how early changes in symptoms can help predict future change.

Cook and colleagues retrospectively examined patients with low back pain who received two weeks of Physical Therapist directed manual therapy (Physiother Theory Pract. 2017).  Patients were followed up to 6 months to determine if early changes in a patient’s pain helped predict who improved the most at 6 months.  The authors reported patients whose pain dropped by 1/3 at 2 weeks were 5-7 times more likely to have reduce pain and disability at 6 months.  Patients whose pain dropped by greater than 50% in first two weeks had similar success at 6 months.  This study supports the re assessment of low back pain patients to help predict long term reductions in pain and disability.