Physical Therapy First for Low Back Pain Reduces Opioid Prescriptions by 85%

Background

Low back pain is really common.  In fact, almost everyone has low back pain at some point in their life, and about 1 in 4 people you know have had low back pain in the past 3 months.  With low back pain being so common, it’s important to have information about the best place to start care when your back does decide to bother you.

Just days ago, a study was published in the prestigious open-access journal “BMJ Open” that looked at how the decision about where to start care can influence the type of care you receive – namely, taking opioids.  You can see the study here.

The Opioid Epidemic

First, a background on opioids.  By now, most people are probably aware of the opioid over-prescription and overdose problem in the United States.  The United States fills approximately 80% of the world’s opioids and 99% of the worlds’ hydrocodone.1  About 130 Americans die every day from an opioid overdose.2   The crazy thing is, we actually now know that opioids really don’t work all that well for pain when compared to less-risky options.  When you compare NSAIDs like ibuprofen to opioids for the treatment of pain caused by cancer, there is no difference in pain reduction!3

The New Research

Back to the study at hand. The researchers were looking back at data on over 216,000 people.  They wanted to see whether short and long-term opioid use was affected by where the person with low back pain first sought care.  Some of the key findings of the study were:

• Nearly 1 in 4 people filled a prescription for opioids for low back pain.
• Going to a physical therapist, chiropractor, or acupuncturist first for low back pain reduced your odds of an opioid prescription by 85-91%.
• Patients with anxiety, depression, bipolar disorder, and fibromyalgia had greater risk of long-term opioid use after filling an initial prescription.

What it Means for You

The findings can really help local Arizonans struggling with low back pain.  Arizonans should know that you do NOT need a referral to access a physical therapist.  In other words, you can simply find a physical therapist who is used to seeing low back pain and start there.  Our clinic’s website has a free ebook on low back pain and is meant to convey a positive message about the condition.  “Hurt does not always equal harm” and “sore but safe” should be mantras to live by. Early activity is essential for episodes of low back pain.  If you have any more specific questions, comment below, shoot us a message on our website, or drop by our clinic in Oro Valley!

Sources:

1.  Opioids Prescribing Practices Perception of Pain – Minnesota Department of Health. https://www.health.state.mn.us/communities/opioids/prevention/painperception.html. Accessed September 29, 2019.
2. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017. Available at http://wonder.cdc.gov.