The American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) has released a position statement opposing “degenerative disc disease” as a diagnostic term for the cause of neck and back pain. AAOMPT publicly announced its position recently during its annual conference in Orlando, Florida.
“Degenerative disc disease is a commonly used term to diagnose an age-related condition that happens when one or more of the discs between the vertebrae of the spinal column changes shape and size,” says Elaine Lonnemann, president of AAOMPT, in a media release.
“These changes are a normal process of aging and not linked to a disease. The use of the term ‘disease’ to diagnose these changes misinforms patients and may lead to unnecessary treatment. We believe that this term does more harm than good.”
AAOMPT recommends that patients seeking care for spinal pain undergo a comprehensive examination to rule out serious medical conditions. Nonpharmaceutical and noninvasive treatments including physical therapy should be the first line of care for patients that do not improve initially on their own.
In the absence of trauma or other systemic health concerns, practice guidelines indicate that imaging studies for patients with low back pain are not necessary before a thorough trial of conservative therapy is completed.
AAOMPT adds in the release that patients often react to the label “degenerative disc disease” by losing hope and seeking more invasive and higher-risk treatments. They avoid beneficial physical activity for fear that exercise and movement will worsen their condition, possibly leading to chronic pain.
The majority of spinal pain is self-limiting and can be managed appropriately without the need for medications or risky procedures such as injections or surgery. For those individuals who do need care, AAOMPT supports and encourages early physical therapy instead of high-risk procedures and medication. AAOMPT strongly recommends that clinicians avoid using the diagnosis of degenerative disc disease.
“We also need to consider the role that orthopaedic manual physical therapists can play in addressing the opioid crisis,” Lonnemann continues.
“Opioids are prescribed for back pain much more commonly than physical therapy. Physicians might prescribe opioids when alternatively, physical therapists could help patients manage their neck and back pain before it becomes chronic. Physical therapists must be a part of the conversation when it comes to the care and management of spinal pain conditions. First line treatment options recommended by most clinical practice guidelines can be effectively delivered by a physical therapist.”
Orthopaedic manual physical therapy is a specialized area of physical therapy practice that uses advanced clinical reasoning to determine the most effective patient management approach that integrates hands-on skilled manual techniques, targeted exercises and education to optimize outcomes including reduction in pain and improvement in function, per the release.
To read the full position statement, visit AAOMPT.
[Source(s): American Academy of Orthopaedic Manual Physical Therapists, PR Newswire]
DDD diagnostic label is used commonly by MDs who refer patients to PT practice. If a claim to insurance for PT is submitted already with this label it has to honored to get reimbursement. In other words, even when “PT worlds” deals with consequences of diseases as DDD , we cannot use different codes by omitting the MD’s label.
At least it is in NY where I practice comprising referring surgeons and PTs.
Correct me if I am wrong, and include resources from the governing body. I will be more than happy to utilize it.
Thank you,
Henryk