Early physical therapy can reduce the risk, the amount of long-term opioid use is studied
Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new study by the researchers at the Stanford University School of Medicine and the Duke University School of Medicine.
The study found that for patients with shoulder, back or knee pain, who used the opioid, the initial physical therapy was related to a reduction of 5 to 10 percent, in which he used the drug.
Between national concern about the excessive use of opiodes and encouraging disease control and prevention centers and other groups, to deploy options, conclusions provide evidence that physical therapy is a useful, nonpharmacologic for the management of severe musculoskeletal pain The approach can be.
"We asked ourselves, 'How can we address people's pain, while the risk of the need for opiodes is not increasing?' 'Eric Sun, MD, PhD, assistant professor of anesthesiology, Peripherative and pain medicine in Stanford. "And what was found in our study that if you can get these patients appropriately on physical therapy, then this possibility It decreases that they will use the opioid for a long time. "
Between 2007 and 2015, the study will be published in the Zima Network Open on December 14, from the analysis of private health insurance claims for care and prescription. Sun is the main author. Steven George, Ph.D., professor of orthopedic surgery at Duke, is a senior writer.
Fewer opioid prescriptions
Researchers have reviewed the claims of external patients and emergency room trips for an initial example of the diagnosis of shoulder, neck, knee or lower back pain among private, insured, non-adult adult patients.
This study was shown to patients who had recently taken an opiate by including people who did not fill the opioid prescription within the previous year. The study also showed patients with less severe pain, which included only those people who had visited the doctor for their condition within 30 days of initial diagnosis and they should have at least one opioid The prescription was given. The last sample included 88,985 patients.
After adjusting to co-microbes such as diabetes and hypertension, the Sun and colleagues found that after three months of initial pain diagnosis, there were fewer obstacles for those who filled an opioid prescription, if they had participated in at least one physical therapy session Within 90 days of their diagnosis. 16% for knee pain patients, 15% for shoulder pain, 8% for neck pain and 7% for lower part of the pain.
In conclusion, the Sun said, looking for pain-management options can be helpful for physicians who take lesser health risk than opiodes. Studies have shown exercise therapy, a component of physical therapy, reduces pain and improves function for some musculoskeletal conditions. Other studies have shown that patients with previous prescriptions for opioid pain medication have increased exposure to high amounts and abuse.
"This is not a world where magic bullets are," said the sun. "But many guidelines point out that physical therapy is an important component of pain management, and it is very less negative to try."
Less need for pain relief
It was also measured in the study that initial physiotherapy therapist was associated with long-term necessity for the lack of opiode, which was in the long duration of the doctors. Researchers measured the amount of opioid by converting the quantity determined into oral morphin into milligrams.
They found that after adjusting factors in confusion, the patients who had undergone initial physical therapy used 10.3 percent less opioid medication for knee pain; 9.7 percent for shoulder pain; And 5.1 percent less for back pain in the period of three months after their diagnosis. There was no significant reduction in neck pain.
According to the study, physical therapy was also associated with less probability within three months of diagnosis that patients with two conditions would have to use opio for long periods of time. After initial physical therapy, patients with knee pain were likely to lose 66% less in three months after the diagnosis of filling 10 or more prescriptions or receiving the supply of opiate for 120 days or more. . Patients with low back pain were 34% less likely to be old, if they had initial physical treatment. There was no connection between physical therapy and chronic opioid use between patients with shoulders or neck pain.
"The consensus is that for the musculoskeletal pain, opioids are not usually long-term solutions," said the Sun. "In addition to all other side effects, even if the medicine is doing well for you, it will also have less and less effect over time because your body produces tolerance."
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