PTOTCohortJournal of occupational rehabilitation2025

How Much Physiotherapy, Chiropractic, and Osteopathy Care Do Compensated Australian Workers with Low Back Pain Receive? A Retrospective Cohort Study.

Michael Di Donato, Shannon Gray, Luke R Sheehan and 3 others

PMID 38761339

WHAT IT FOUND

Most compensated Australian workers with low back pain attend physical therapy, with 82% seeing a physiotherapist, chiropractor or osteopath.

Median attendances were 13 for physiotherapy only, 8 for chiropractic only, 10 for osteopathy only, and 31 for multiple professions. Jurisdiction strongly influenced care patterns.

Key findings

0182% of workers attended at least one physical therapy service, with physiotherapists seeing 89.5% of those receiving care.

02Workers attending multiple professions had a median of 31 attendances, compared to 13 for physiotherapy only, 8 for chiropractic only, and 10 for osteopathy only.

03Jurisdiction significantly affected care, with Victorian workers less likely to attend any physical therapy but more likely to see osteopaths or multiple professions than Queensland workers.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study used administrative data which lacked clinical information such as pain severity, disability scores, or specific treatment modalities provided, preventing analysis of whether care was clinically appropriate. Only services funded by workers' compensation were included, meaning care paid for privately or through other insurance was missed, likely underestimating total service utilization. Return to work outcomes could not be reliably measured, so the relationship between attendance patterns and functional recovery remains unclear. The data were from 2011-2015, so current policies and clinical practices may differ.

The easy way to misread this

Do not assume that the high number of attendances indicates effective or necessary care. The study shows patterns of utilization but cannot determine if these sessions improved patient outcomes or adhered to clinical guidelines, as no treatment content or patient outcomes were measured.

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