How Physical Therapy May Help Reduce Opioid Use

By Kelly Burch 12/19/18

Researchers combed through insurance claims of chronic pain patients to determine if physical therapy could help reduce their pain enough to cut back on their pain meds.

chronic pain patient in physical therapy to reduce opioid use

Getting physical therapy early on may help pain patients reduce their long-term opioid use by about 10%, according to research published this week in the journal JAMA Network Open

“By serving as an alternative or adjunct to short-term opioid use for patients with musculoskeletal pain, early physical therapy may play a role in reducing the risk of long-term opioid use,” the study authors wrote. “Early physical therapy appears to be associated with subsequent reductions in longer-term opioid use and lower-intensity opioid use for all of the musculoskeletal pain regions examined.”

To conduct the study, researchers reviewed the insurance claims of 88,985 patients with shoulder, neck, knee or low back pain. They found that using physical therapy, as recommended by best practices, is associated with reduced opioid use. Since long-term opioid use can lead to dependence and addiction, physical therapy could potentially help reduce those conditions. 

“Using early physical therapy, consistent with recent clinical guidelines, could play an important role in reducing the risk of transitioning to chronic long-term opioid use for patients with shoulder, neck, knee, and low back pain,” researchers wrote. 

The director of the division of integrative pain management at Mount Sinai Hospital in New York City, Dr. Houman Danesh, said this study shows how important physical therapy can be in long-term pain relief. 

"You can take an opioid for a month, but if you don't get at the underlying issue [for the pain], you'll go back to where you started,” Danesh, who wasn’t involved with the study, told WebMD. Getting physical therapy can help patients address the underlying cause of their pain. 

However, he pointed out that it’s critical to have access to high-quality physical therapists.

"Physical therapy is highly variable," he said. "Not all physical therapists are equal -- just like not all doctors are.”

Dr. Eric Sun, who teaches anesthesiology, perioperative and pain medicine at Stanford University and who led the study, said patients should consider trying physical therapy instead of relying solely on opioid pain relief. 

"For people dealing with these types of musculoskeletal pain, it may really be worth considering physical therapy — and suggesting that your health care provider give you a referral,” he said. 

Sun pointed out that the study merely established a link between physical therapy and lower opioid use; it did not prove that physical therapy causes people to use fewer opioids. 

"Since physical therapy is more work than simply taking an opioid, patients who are willing to try physical therapy may be patients who are more motivated in general to reduce opioid use,” he said. 

Please read our comment policy. - The Fix
Kelly Burch Contrib.jpg

Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.