Cost-effectiveness of physical therapy and general practitioner care for sciatica

Area of Science:

• Health Economics
• Clinical Practice
• Rehabilitation Medicine

Background:

• Limited data exists on the cost-effectiveness of physical therapy for sciatica.
• Sciatica, or acute lumbosacral radicular syndrome (LRS), is a common condition requiring effective treatment strategies.

Purpose of the Study:

• To assess the cost-effectiveness of physical therapy combined with general practitioner (GP) care versus GP care alone for acute LRS.
• To compare clinical outcomes and healthcare costs between the two treatment groups.

Main Methods:

• A randomized clinical trial with economic evaluation was conducted in primary care.
• 135 patients with LRS were randomized to either physical therapy plus GP care (n=67) or GP care alone (n=68).
• Clinical outcomes (perceived recovery, quality of life) and costs (direct, indirect) were measured over a 1-year follow-up. Incremental Cost-Effectiveness Ratio (ICER) was calculated.

Main Results:

• Patients receiving physical therapy showed significantly better perceived recovery at 1-year follow-up.
• No significant incremental benefit in quality of life was observed with the addition of physical therapy.
• The ICER for total costs was €6224 per improved patient; for direct costs, it was €837.

Conclusions:

• Physical therapy combined with general practitioner care is not more cost-effective than general practitioner care alone for patients with acute LRS.
• The findings suggest that current economic models may not fully capture the value of physical therapy in sciatica management.
• Further research may be needed to explore specific patient subgroups or alternative outcome measures.