Though Americans spend an estimated $80 billion to $100 billion each year in hopes of easing their aching backs, the evidence is mounting that many pricey standard treatments — including surgery and spinal injections — are often ineffective and can even worsen and prolong the problem.

A study published in the journal Health Services Research suggests trying physical therapy first may at least ease the strain on the patient's wallet in the long term — and also curb reliance on opioid painkillers, which carry their own risks.

Overall, patients saw "significantly lower out-of-pocket costs — on the average, $500 — when they visited a physical therapist first," said Bianca Frogner, a health economist at the University of Washington School of Medicine in the Department of Family Medicine.  She was the lead author on the study.

Please see news release from Wiley, the journal publisher.