scholarly journals Does early physical therapy intervention reduce opioid burden and improve functionality in the management of chronic lower back pain?

2020 ◽  
Vol 10 (4) ◽  
pp. 215-221
Author(s):  
Shedrick Martin ◽  
Kimberly Tallian ◽  
Victoria T. Nguyen ◽  
Jason van Dyke ◽  
Harminder Sikand

Abstract Introduction Chronic lower back pain is a leading cause of disability in US adults. Opioid use continues to be controversial despite the Centers for Disease Control and Prevention guidance on chronic pain management to use nonpharmacologic and nonopioid pharmacologic interventions. The objectives of the study were to assess the impact of early physical therapy (PT) intervention on improving functionality and reducing opioid burden in patients with chronic lower back pain. Methods A single-center, retrospective chart review of patients receiving ≥6 PT visits and treated with either opioids first (OF) or PT first (PTF) therapy for chronic lower back pain were evaluated. Concomitant use of nonopioid and nonpharmacologic therapy was permitted. The Oswestry Disability Index (ODI), a survey measuring functionality, was recorded for PTF group. Pain scores and medication use including opioids were collected at treatment initiation and completion. Results One hundred and eighty patients were included in three groups: OF group (n = 60), PTF group (n = 60), and PTF + ODI group (n = 60). The PTF + ODI group had mean ODI reduction of 11.9% (P < .001). More OF patients were lost to follow up (68.3%) or failed PT (60%) compared to the PTF group, 38.3% and 3.3% (P < .001). Reduction in both opioid and nonopioid medications as well as pain scores were observed but not statistically significant. Discussion Early PT resulted in improved functionality, decreased pain, and reduced medication use upon PT completion. These findings suggest PT, along with nonopioid modalities, are a viable first-line option for the management of chronic lower back pain.

2010 ◽  
Vol 47 (5) ◽  
pp. 586-592 ◽  
Author(s):  
Marie Crowe ◽  
Lisa Whitehead ◽  
Mary Jo Gagan ◽  
G. David Baxter ◽  
Avin Pankhurst ◽  
...  

2021 ◽  
Vol 22 (5) ◽  
pp. 590-591
Author(s):  
Taylor Buchanan ◽  
Deanna Rumble ◽  
Kristen Watts ◽  
Danica DeJesus ◽  
Tammie Quinn ◽  
...  

2019 ◽  
Vol 15 (5) ◽  
pp. 703-708 ◽  
Author(s):  
Ardalan Shariat ◽  
Reza Alizadeh ◽  
Vahideh Moradi ◽  
Elahe Afsharnia ◽  
Azadeh Hakakzadeh ◽  
...  

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 3
Author(s):  
Kyoung-Sim Jung ◽  
Jin-Hwa Jung ◽  
Tae-Sung In ◽  
Hwi-Young Cho

Background and Objectives: This study investigated the effects of prolonged sitting on trunk muscular fatigue and discomfort in participants with and without chronic lower back pain (LBP). Material and Methods: This study included 15 patients with LBP and 15 healthy controls. All participants were instructed to sit on a height-adjustable chair with their knee and hip joints bent at 90° for 30 min, in slumped sitting postures. Surface electromyography was used to assess the median frequency of the internal obliques (IO)/transversus abdominis (TrA) and multifidus (MF) muscles. Perceived discomfort was measured using a Borg category ratio-scale. Median frequency of the trunk muscles and perceived discomfort after 30 min of sitting were compared with baseline. Result: There were no significant differences within the group and between both groups in the median frequency of bilateral IO and MF muscles. The LBP group showed significantly greater perceived discomfort after prolonged sitting, as compared to the control group. Conclusions: Prolonged sitting with slumped posture could increase the risk of experiencing lower back discomfort.


2021 ◽  
Vol 14 ◽  
pp. 117954412199377
Author(s):  
Philip Muccio ◽  
Josh Schueller ◽  
Miriam van Emde Boas ◽  
Norm Howe ◽  
Edward Dabrowski ◽  
...  

Chronic lower back pain is one of the most common medical conditions leading to a significant decrease in quality of life. This study retrospectively analyzed whether the AxioBionics Wearable Therapy Pain Management (WTPM) System, a customized and wearable electrical stimulation device, alleviated chronic lower back pain, and improved muscular function. This study assessed self-reported pain levels using the visual analog scale before and during the use of the AxioBionics WTPM System when performing normal activities such as sitting, standing, and walking (n = 69). Results showed that both at-rest and activity-related pain were significantly reduced during treatment with the AxioBionics WTPM System (% reduction in pain: 64% and 60%, respectively; P < .05). Thus, this study suggests that the AxioBionics WTPM System is efficacious in treating chronic lower back pain even when other therapies have failed to sufficiently decrease reported pain levels.


2011 ◽  
Vol 16 (1) ◽  
pp. 41-43 ◽  
Author(s):  
He Shuchang ◽  
He Mingwei ◽  
Jia Hongxiao ◽  
Wu Si ◽  
Yang Xing ◽  
...  

OBJECTIVE: To investigate the emotional and neurobehavioural status of patients suffering from chronic pain.METHODS: Fifteen male patients with chronic lower back pain and 15 healthy control subjects were studied for approximately six months. Pain was measured using a visual analogue scale. The WHO Neurobehavioral Core Test Battery (NCTB) was used to assess neurobehavioural effects of environmental and occupational exposures.RESULTS: Visual analogue scale results demonstrated a modest range of reported pain (mean [± SD] 62.0±10.8) in chronic pain patients, whereas control subjects reported no measurable pain. With the NCTB, it was found that scores of negative mood state, including anger-hostility, depression-dejection, fatigue-inertia and tension-anxiety in pain patients were significantly higher than scores in the control subjects. By contrast, scores of positive mood state (vigour-activity) in chronic pain patients were lower than those in the control group. The NCTB scores of the Santa Ana Dexterity and Pursuit Aiming II tests in chronic lower back pain patients were lower than those of the control group. Scores for other NCTB sub-tests, including the Digit Span, Benton Visual Retention and Digit Symbol tests, were not significantly different compared with controls.CONCLUSIONS: Chronic lower back pain patients had more negative mood and less positive mood than controls. These patients also demonstrated neuromotor deficits in coordination and reaction time. Further studies are required to examine possible neurological mechanisms and research potential intervention strategies for patients suffering from chronic pain.


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