Early physical therapy is linked to reduced subsequent opioid use in patients with musculoskeletal pain, according to a recent study.
For patients with back, shoulder, or knee pain who use opioids, early physical therapy is important. According to a study, it was linked to a 5 to 10 percent drop in how much of the medication they used.
Amid national concern regarding the overuse of opioids and encouragement from the Centers for Disease Control and Prevention and other groups to arrange alternatives when possible.
Hence, the findings offer evidence that physical therapy can be a beneficial, nonpharmacological approach for dealing this musculoskeletal pain.
“We questioned ourselves, ‘How can we manage the pain from which people are suffering from, while not increasing their opioids risk?'” said Eric Sun. He is an MD, Ph.D., assistant professor of anesthesiology, perioperative and pain medicine at Stanford.
“And our study found that if these patients get physical therapy reasonably rapidly, that decreases the possibility that they’ll be using opioids in the longer term.
Fewer opioid prescriptions
The scientists studied claims for outpatient and emergency room visits. They observed the earliest case of analysis of neck, shoulder, knee or low back pain among privately insured, nonelderly adult patients.
Hence, the study separated patients who had just taken opioids. It included only those who had not filled an opioid prescription within the previous year.
The study also screened out those with less serious pain. It also comprised only those patients who had visited a doctor within 30 days of their initial diagnosis. And were given at least one prescription of an opioid within 90 days. The final sample involved 88,985 patients.
After adjusting for co-morbidities, Sun and his team observed that the odds of participants filling an opioid prescription 3 months to a year after their early diagnosis were lower if they had undergone at least one physical therapy session within 90 days of their pain diagnosis.
The chances were decreased by 16 percent for patients with knee pain, 8 percent for neck pain, 15 percent for shoulder pain and 7 percent for lower back pain.
The findings could be supportive to clinicians in hunt of pain-management possibilities which carry rarer health risks than opioids. Studies have exposed exercise therapy decreases pain and advances function for some musculoskeletal problems. As exercise therapy is a constituent of physical therapy.
Other studies have revealed that patients with past opioid pain medication are at higher risk for misuse and overdose.
Less need for pain relief
Researchers also observed whether early physical therapy was linked to a reduced opioid need among those who filled prescriptions. The scientists measured the number of opioids by changing prescribed quantities to oral morphine milligram equivalents.
In the period three months to a year, researchers found that patients who had undergone early physical therapy used;
- 7 percent less opioid medication for shoulder pain
- 3 percent less for knee pain
- 1 percent less for back pain.
- no significant reduction for neck pain
However, physical therapy within three months of diagnosis was linked to a decreased probability that patients with two of the problems would frequently use opioids in the long term, according to the study.
After initial physical therapy, patients with knee pain were 66 percent less probable in three months to a year after their diagnosis to either fill 10 prescriptions or more or get opioid medication for 120 days or more.
Patients with low back pain were 34 percent less expected to be lasting users if they had initial physical therapy. There was no link between physical therapy and chronic opioid use in patients with neck or shoulder pain.
“The consensus is that for musculoskeletal pain, opioids normally are not a long-term solution,” Sun said.
“Aside from all side effects, even if the medicine is doing fine for you, it will have less and less result over time as your body builds up a tolerance.”