Emergency Department Physiotherapist Reduces Imaging, Opioids, & Length of Stay

Data continues to emerge regarding how it affects care and patient outcomes. In April, PLoS One published a first-of-its-kind study in this area. In addition to the important data collected, the researchers’ conclusions serve as a good reminder of how patients benefit when physiotherapy is used as a first-line approach in musculoskeletal pain (MP).

Dr. Andrew Pugh and colleagues prospectively tracked patients presenting with MP to an urban academic emergency department (ED).1 This emergency department used a dedicated physiotherapist only three days a week. This scenario enabled researchers to compare patients denied ED physio to patients afforded ED physio. Most patients presented with cervical, thoracic, or lumbar pain.

These results echo studies in outpatient care showing that access to physiotherapy for MP, especially prompt access to physiotherapy, lowers costs, rates of advanced imaging, the need for injections, and the need for surgery, while raising patient satisfaction.2-6. Immediate referrals to physiotherapy give patients with MP access to a musculoskeletal specialist for assessment, safe early mobility, and time dedicated to education and reassurance. Even among patients with concerns severe enough to merit an ED visit, many can be helped and satisfied with conservative.

approaches and without opioids, when a musculoskeletal specialist is available. Out patient physiotherapy is no substitute for an ED. Physiotherapists in an ED can quickly refer medical cases to the ED physicians. However, the current study reaffirms that many outpatient cases of acute MP are appropriate for immediate referral to physiotherapy. As guidelines indicate, physiotherapy is not a last resort approach after imaging, strong analgesics, waiting, etc.7-9 Physiotherapy works best for patients and payors when delivered as early as possible in the course of treating musculoskeletal pain.

Rehab Facility

Special Teams: Lower Limb,

Shoulder & Spine

References

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sen T. Dedicated emergency department physical therapy is associated with reduced imaging,

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Apr 23;15(4):e0231476.

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Clinical Rheumatology. 2016 Dec 1;30(6):968-80.