Is physical therapy cost-effective care for sciatica?

Not when compared to general practitioners’ care alone, according to researchers from Erasmus Medical Center in Rotterdam, the Netherlands.

First, the details.

  • 135 patients were randomly assigned to physical therapy plus general practitioners’ care or to general practitioners’ care alone.
  • Patients were monitored for a year.
  • The clinical outcomes were global perceived effect and quality of life.
  • The fiscal outcomes were direct and indirect costs measured by means of questionnaires.
  • An incremental cost-effectiveness ratio (ICER) was used to compare the cost of treatments.
    • ICER is a pharmcoeconomics tool to compare the change in the cost of one treatment vs an alternative (eg, placebo or the best available alternative treatment) to the change in effect of the treatment.

And, the results at one year.

  • There was a significant difference in perceived recovery in favor of the physical therapy group.
  • Physical therapy beyond that time did not improve quality of life more.
  • The ICER for the total costs (physical therapy plus primary care) was 6224 euros (about US$9000) per improved patient gained. For direct costs of physical therapy only, the ICER was 837 euros (about US$1200).

The bottom line?
It’s a bit confusing. But despite the fact that patients favored physical therapy, for the treatment of sciatica (aka acute lumbosacral radicular syndrome), the added cost of physical therapy (in addition to the time lost from work to attend the treatment sessions) isn’t a good use of the money.

1/23/08 11:13 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.