Relationships between physical therapy intervention and opioid use: A scoping review.
Lindsey Brown-Taylor, Aaron Beckner, Katie E Scaff and 5 others
PMID 34153178WHAT IT FOUND
Early physical therapy for low back pain was consistently linked to lower odds of opioid use in five of six studies.
However, evidence for other PT interventions, modalities, or interdisciplinary programs remains weak, inconsistent, or null.
Key findings
01Receipt of early PT was associated with significantly reduced odds of opioid prescription in five of six studies evaluating low back pain.
02Interdisciplinary pain programs including PT showed conflicting results, with some studies finding no significant reduction in the percent of participants using opioids at discharge.
03Guideline-adherent PT care for low back pain did not have a significant relationship with opioid use or prescription in the 6–24 months post-treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review included a wide variety of PT interventions and patient populations, making it difficult to draw specific conclusions. 20 of the 30 studies were retrospective, which cannot establish causality. Many studies did not account for baseline opioid use or history of substance abuse, which are strong predictors of future use. Only 50% of the included studies were rated as good quality; 17% were poor quality. The definition of 'early PT' varied across studies, ranging from PT as the initial visit to PT within 90 days.
Declared interests
The paper states it was supported by the U.S. Government (Non-P.H.S.). No commercial conflicts of interest are explicitly detailed in the provided text, but the funding source is noted.
The easy way to misread this
Do not interpret the association between early PT and reduced opioid use as proof that PT causes patients to stop taking opioids. The majority of studies were retrospective and could not control for all confounding factors, such as pre-existing opioid use or patient motivation.