For patients with musculoskeletal pain, early physical therapy is associated with reduced subsequent opioid use, according to a study published online Dec. 14 in JAMA Network Open.

Eric Sun, M.D., Ph.D., from the Stanford University School of Medicine in California, and colleagues examined the correlation between early physical therapy and subsequent opioid use in 88,985 opioid-naive patients aged 18 to 64 years with a new diagnosis of musculoskeletal shoulder, neck, knee, or low back pain.

Of the patients, 29.3 percent received early physical therapy. The researchers found that early physical therapy correlated with a statistically significant reduction in any opioid use between 91 and 365 days after the index date for patients with shoulder, neck, knee, and low back pain (odds ratios, 0.85, 0.92, 0.84, and 0.93, respectively) after adjustment for potential confounders. Early physical therapy was also associated with a statistically significant reduction in the amount of opioid use among patients who used opioids for shoulder, knee, and low back pain (−9.7, −10.3, and −5.1 percent, respectively) but not for neck pain.

"This isn't a world where there are magic bullets," Sun said in a statement. "But many guidelines suggest that physical therapy is an important component of pain management, and there is little downside to trying it."

Two authors disclosed financial ties to the medical technology and rehabilitation industries.

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