To the Editor

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Letter to the Editor Regarding “Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial”
Honorably, it is with great interest to read the article by Fritz et al entitled “Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial” (Spine, Volume 42, Issue 5, pp. 285–290). Based on our experience, some points should be concerned.
In this article, it was so convincingly designed by randomized analysis. Unfortunately, data were collected involving 220 participants ages 18 to 60 years. We doubt the statistical data consistency due to the multiple factors especially degeneration, as we all know. Even then, recurrent character should also be taken into consideration.
Moreover, as for cost, the surgical financial is a most commendable issue worldwide. For patients with low back pain, a cost-effective protocol aided by physical therapist should be recommended, similar result with Dr. Roelofs, which conclude that lumbar support seemed to be a cost-effective addition to usual care for home care workers with recurrent low back pain.1
In aging society, low back pain is a huge medical and a big economical issue. How to care about this big population always comes out as the top priority.

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