Early Physical therapy helps reduce post op opioid prescription : JAMA

A new study published in the JAMA Network has reported that 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.

Musculoskeletal pain is a common condition that imposes a substantial morbidity burden.A particularly concerning aspect of musculoskeletal pain is the potential for patients to transition to chronic opioid use, with prescription opioids playing a role in more than a third of drug overdose deaths.

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Eric Sun and associates conducted a cross-sectional analysis to determine the association between early physical therapy and subsequent opioid use in patients with new musculoskeletal pain diagnosis.

The authors found that cross-sectional analysis of 88 985 patients with shoulder, neck, knee, or low back pain, early physical therapy was associated with an approximately 10% statistically significant reduction in subsequent opioid use. For patients with low back, shoulder, and knee pain who did use opioids, early physical therapy was associated with a 5% to 10% reduction in oral morphine milligram equivalents(MMEs). The authors found no association between early physical therapy and subsequent MMEs for patients with neck pain.

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“However, our study clearly shows that patients can recover from major surgery just as well with over-the-counter pain medications such as ibuprofen or acetaminophen and minimal or no opioids, with no increase in pain or postoperative complications, "write the authors.

A large number of patients have been routinely prescribed opioids for acute pain following surgery despite the serious risks associated with opioid use, such as addiction, overdose, and death. Opioid misuse has become a major health and economic issue claiming more than 100 lives per day. Nearly 5 million people misuse prescription pain relievers each year, and 80% of heroin users report that their addiction started with a prescription opioid painkiller.