Early physical therapy may reduce long-term opioid use in opioid-naive patients with musculoskeletal pain
Early physical therapy may correlate with a decrease in long-term and low-intensity opioid use for pain in musculoskeletal regions among opioid-naïve patients, according to recently published results.
“[The] take-home message of the study is that for patients with severe musculoskeletal pain, getting early physical therapy may help reduce the probability that they will use opioids long-term,” Eric Sun, MD, PhD, told Healio.com/Orthopedics. “As such, it’s a treatment that they (and their physicians) should consider.”
Researchers performed a cross-sectional analysis and identified 88,985 opioid-naïve patients who presented with musculoskeletal shoulder, neck, knee or low back pain to an outpatient physician office or an emergency department. Investigators noted the data set included person-level IDC-9 or IDC-10 codes, CPT codes, date of service and pharmaceutical information. Some patients were assigned to early physical therapy, which meant the patient received at least one session of physical therapy within 90 days of the index date. The index date was the earliest date a relevant diagnosis was provided to a patient. The primary outcome was opioid use between 91 and 365 days after the index date.
There were 26,096 patients who received physical therapy. After potential cofounders were adjusted, investigators noted early physical therapy correlated with a statistically significant decrease in the incidence of opioid use between 91 and 365 days after the index date for patients with shoulder, neck, knee and low back pain. Early physical therapy for patients who did use opioids preoperatively correlated with an approximately 10% statistically significant decrease in the amount of opioid use, measured in oral morphine milligram equivalents for shoulder, knee and low back pain; however, it did not correlate with a decrease in the amount used for neck pain. – by Monica Jaramillo
Disclosures: Sun reports support in part by grant K08DA042314 from the National Institute on Drug Abuse. Please see the full study for a list of all other authors’ relevant financial disclosures.