Early Physical Therapy could help diminish the need for Opioid Use
- From the Journal of American Medical Assn. STUDY

The evidence of physical therapy's potential to make a difference in the nation's opioid crisis continues to mount—this time, by way of a study in the Journal of American Medical Association Network Open, which concludes that for patients experiencing back, knee, neck, or shoulder pain, a visit to a physical therapist (PT) early on can reduce the chances that they'll take any opioids for the condition. And among those who do wind up taking opioids during the episode of care, researchers identified an association, albeit less strong, between early physical therapy and reduced number of pills taken for 3 of the 4 conditions.

The patients, a national sample from multiple health networks, were 57.7% male with an average age of 46. Comorbidities and demographic factors were similar among both groups. Overall, 29.3% of the patients received early physical therapy.

Here's what researchers found:

Early physical therapy was associated with a reduced risk of any opioid use for all 4 conditions:
16% drop for knee pain patients,
15% reduction for those with shoulder pain
8% for neck pain, and
7% for low back pain (LBP).

Among patients who were prescribed (and used) opioids, early physical therapy seemed to have an association with fewer pills taken for 3 of the 4 conditions. Patients with knee pain recorded a 10.3% drop in oral morphine milligram equivalents taken compared with the control group; those with shoulder pain saw an average 9.7% reduction; and the LBP subgroup averaged a decline of 7%. The neck pain subgroup showed a slight 3.8% drop—not enough to be statistically significant, according to the study's authors.

"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 said. "This study does not suggest those receiving early physical therapy had better clinical outcomes. That's an important thing to remember when interpreting these findings."