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Objective
Costs associated with low back pain (LBP) continue to rise. Despite numerous clinical practice guidelines, the evaluation and treatments for LBP are variable and depend largely on the individual provider. As yet, little attention has been given to the first choice of provider. Early research indicates that the choice of first provider and the timing of interventions for LBP appear to influence utilization. This study sought to examine the association between the first provider seen and utilization.

Conclusion
Overall, there appears to be an association between the first choice of provider and future health care utilization. Chiropractic care and physical therapy provide nonpharmacologic and nonsurgical, guideline-based interventions. Their participation appears related to a decrease in immediate and long-term utilization of heath care resources. This study expands the existing body of literature and provides a compelling case for the influence of the first provider on an acute episode of LBP.