The Journal of the American Medical Association (JAMA) recently published Association of Early Physical Therapy With Long-term Opioid Use Among Opioid-Naïve Patients With Musculoskeletal Pain.
The study analyzed 88,985 private health claims focused on shoulder, neck, knee, or low back pain, seeking to understand how early physical therapy – defined as physical therapy initiated within three months of injury – impacted long-term opioid use. The study examined prescriptions in these claims from 2007-2015 and found that physical therapy within three months of a musculoskeletal pain diagnosis reduced the probability of opioid use over the long term by 10%.
The odds of patients filling an opioid prescription three months to a year after their initial pain diagnosis were lower if they had participated in at least one physical therapy session within 90 days of their diagnosis. Broken down by body part, these odds were reduced:
- 16% for knee pain
- 15% for shoulder pain
- 8% for neck pain
- 7% for lower back pain
In addition to lowering the odds of long-term opioid use, early physical therapy also reduced the amount of opioids used by patients who did take opioids. Patients who underwent early physical therapy used:
- 10.3% less opioids for knee pain
- 9.7% less opioids for shoulder pain
- 5.1% less opioids for back pain
No significant reductions in opioid use were found for those suffering from neck pain who engaged in early physical therapy, but overall the research indicates that physical therapy can reduce opioid use in patient populations.