Early PT for Low Back Pain May Reduce Need for Opioids


In the face of an ongoing national epidemic of opioid abuse, medical experts are looking for strategies to lower the risk of addiction for patients in pain. One approach may be the early use of physical therapy for low back and other types of musculoskeletal pain.

Researchers analyzed data from 88,985 men and women, ages 18 to 64, who went to a doctor’s office or a hospital emergency department for treatment of musculoskeletal pain. Among them, 26,096 received early physical therapy. Those who had at least one physical therapy session within 90 days of their initial visit were about 10 percent less likely than those who didn’t to use opioid medications long-term for shoulder, neck, knee, or low back pain.

Physical therapy was also associated with a 5 to 10 percent reduction in the amount of opioid medications used. The findings showed patients who received a physical therapy session within 30 days of seeking pain treatment were the least likely to use any opioids.

The study, which was published in 2018 in JAMA Network Open, was observational, meaning it doesn’t prove cause and effect. With such a diverse group of study participants, unmeasured factors may have affected the outcomes.

Still, for some people, the findings suggest, early physical therapy alone may be enough to control low back and other types of musculoskeletal pain, eliminating any need for opioid medications. For others, the benefits of early physical therapy may mean using less medication.