Can Early Physical Therapy Reduce Opioid Use? New Research Says Yes!
Opioids shouldn't be the first or only approach to treating most chronic pain.
That's the bottom line message of the Centers for Disease Control and Prevention (CDC) guidelines related to prescribing opioids for chronic pain, which were released in March 2016.
Now a study published in JAMA provides new evidence to support those recommendations.
In the study, researchers found that people who were treated by a physical therapist soon after their diagnosis for the 4 most common musculoskeletal conditions—back pain, knee pain, neck pain, and shoulder pain—were less likely to be prescribed opioids later in their treatment episode.
When patients with those conditions sought physical therapy early, subsequent opioid use reduced by approximately 10 percent for the following year (results varied by condition).
A 'Viable Option' for Preventing Long-Term Opioid Use
"This study provides early evidence that the CDC guidelines may help decrease long-term opioid use," said Steven George, PT, PhD, one of the study's contributing researchers. "The biggest takeaway is that early physical therapy may be a viable option for several musculoskeletal conditions, especially if preventing long-term opioid use is a treatment goal."
George cautioned that the study doesn't suggest that early treatment by a physical therapist was related to better clinical outcomes—simply that people who were treated by a physical therapist first were less likely to be prescribed with opioids later.
"This isn't a world where there are magic bullets," said Eric Sun, MD, PhD, an author of the study. "But many guidelines suggest that physical therapy is an important component of pain management, and there is little downside to trying it."
What the CDC Guidelines Say
The CDC guidelines encourage nonopioid approaches such as physical therapy when:
- The risks of opioid use outweigh the rewards
- Patients want to do more than mask the sensation of pain
- Opioids are prescribed for pain-as combining opioid treatment with nonopioid approaches can help keep opioid dosage and usage as low as possible
- Pain lasts 90 days, becoming a "chronic" condition
The guidelines make clear that prescription opioids are still appropriate in some cases-including cancer treatment, palliative care, and end-of-life care—if properly dosed.
How Physical Therapists Can Help
Physical therapists are movement experts who optimize quality of life through prescribed exercise, hands-on care, and patient education.
After making a diagnosis, physical therapists create personalized treatment plans that help their patients improve mobility, manage pain and other chronic conditions, recover from injury, and prevent future injury and chronic disease.
Physical therapists empower people to be active participants in their own treatment, and they work collaboratively with other health professionals to ensure that patients receive comprehensive care.
What You Should Do
If you're experiencing chronic pain, talk to your health care provider about your goals and the options for your care.
This downloadable pain profile self-assessment can help you have a conversation with your physician or physical therapist to determine the best treatment plan for you.
Learn more about how physical therapists can help safely manage pain.