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Relationships between physical therapy intervention and opioid use: A scoping review
Lindsey Brown-Taylor1,2, Aaron Beckner1,3, Katie E Scaff4
1Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.
Summary
Early physical therapy (PT) utilization is linked to reduced opioid use for various pain conditions. However, evidence on PT
Area of Science:
- Orthopedics and Pain Management
- Rehabilitation Sciences
- Public Health and Epidemiology
Background:
- Opioid use remains a significant public health concern, particularly for chronic pain conditions.
- Physical therapy (PT) is a non-pharmacological approach often considered for pain management.
- Understanding the relationship between PT and opioid use is crucial for optimizing pain treatment strategies.
Purpose of the Study:
- To synthesize existing evidence on the association between physical therapy interventions and opioid use.
- To identify specific PT parameters (e.g., timing, utilization) that may influence opioid prescribing patterns.
- To evaluate the overall impact of physical therapy on reducing reliance on opioid medications.
Main Methods:
- A comprehensive scoping review was conducted, searching major academic databases (PubMed, Embase, CINAHL, etc.) for relevant studies.
- Studies published up to October 2019, examining physical therapy interventions and opioid use outcomes, were included.
- Data extraction focused on PT intervention details, patient characteristics, opioid use measures, and study quality assessment.
Main Results:
- Thirty studies were included, examining PT in various contexts including interdisciplinary programs, modalities, and timing of care.
- Utilizing PT was associated with lower odds of opioid medication use for low back pain and injured workers (odds ratios 0.2-0.8).
- Early PT initiation after pain onset or surgery showed a consistent association with reduced subsequent opioid use (odds ratios 0.27-0.93).
Conclusions:
- Early and consistent utilization of physical therapy appears to be associated with decreased opioid medication use.
- Evidence regarding the impact of PT content and location on opioid use is limited and inconclusive due to study heterogeneity.
- Further research is needed to clarify the optimal parameters of physical therapy for opioid-sparing pain management.
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