Managed Physical Medicine

Early Physical Therapy Linked to Lower Opioid Use in Landmark Study

The opioid crisis has been declared a national Public Health Emergency. Can physical therapy help curb opioid use among musculoskeletal patients?

A December 2018 study published in JAMA Network Open caps off a growing body of research demonstrating early physical therapy’s association with reduced opioid use. The study, which looked at data from 88,985 privately insured patients who visited their provider with back, knee, neck or shoulder pain, found that those who received physical therapy treatment within 3 months were less likely to take opioids for their condition. 

Researchers tracked opioid prescription and use data over the course of one year among the two patient groups: those who had PT within 90 days of the index visit and those who didn’t. Researchers found that early PT was associated with a reduced risk of opioid use for all conditions: knee pain (-16%), shoulder pain (-15%), neck pain (-8%) drop and low back pain (-7%). Among patients who were prescribed and used opioids, an association between early PT and a reduction in pills was noted for all conditions except the neck pain subgroup. Notably, patients who received early PT had a significant reduction in the likelihood of chronic opioid use in two subgroups: 66% for knee pain and 33% of low back pain.

The time to PT treatment varied among participants by condition, ranging from an average of 13 days after index visit for neck pain to 40 days for shoulder pain. The positive outcomes of this study drive home the importance of early physical therapy treatment. MedRisk’s managed physical medicine program matches injured workers with the right physical therapist as quickly as possible – with an average of 4 hours to scheduling and 2.6 days to initial treatment.

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Sun, E., Moshfegh, J., Rishel, C. A., Cook, C. E., Goode, A. P., & George, S. Z. (2018). Association of Early Physical Therapy With Long-term Opioid Use Among Opioid-Naive Patients With Musculoskeletal Pain. JAMA network open, 1(8), e185909-e185909.