‘Enhanced recovery’ protocol reduces opioid use in spinal surgery patients

A novel “Enhanced Recovery After Surgery” (ERAS) protocol developed by Penn Medicine for patients undergoing spinal and peripheral nerve surgery significantly reduced opioid use. A new study published in the Journal of Neurosurgery: Spine showed that when an ERAS protocol was employed—which optimizes patients’ surgical care before, during, and after surgery, including patient education, post-operative medications, and recovery plans—fewer patients needed pain medications one month after surgery.

Nearly 75 percent of patients at Penn Medicine who undergo spinal surgeries are opioid naïve—patients who are not chronically taking opioids on a daily basis—putting them at an increased risk for dependency following surgery. Previous studies have also shown that up to 7 percent of all patients who undergo spinal surgeries continue to take opioids one year after surgery. Part of the ERAS protocol at Penn includes a personalized, safe, and effective pain management plan to help prevent opioid dependency, which has rapidly become a public health crisis in the United States.

Full story at Medical Xpress

Early physical therapy associated with reduction in opioid use

Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new study by researchers at the Stanford University School of Medicine and the Duke University School of Medicine.

For patients with shoulder, back or knee pain who did use opioids, early physical therapy was associated with a 5 to 10 percent reduction in how much of the drug they used, the study found.

Amid national concern about the overuse of opioids and encouragement from the Centers for Disease Control and Prevention and other groups to deploy alternatives when possible, the findings provide evidence that physical therapy can be a useful, nonpharmacologic approach for managing severe musculoskeletal pain.

Full story at news-medical.net

Early physical therapy associated with reduction in opioid use

Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new study by researchers at the Stanford University School of Medicine and the Duke University School of Medicine.

For patients with shoulder, back or knee pain who did use opioids, early physical therapy was associated with a 5 to 10 percent reduction in how much of the drug they used, the study found.

Amid national concern about the overuse of opioids and encouragement from the Centers for Disease Control and Prevention and other groups to deploy alternatives when possible, the findings provide evidence that physical therapy can be a useful, nonpharmacologic approach for managing severe musculoskeletal pain.

Full story at news-medical.net

PTJ Special Issue Podcasts: Physical Therapy for Pain May Reduce Overall Costs, Opioid Use

For some patients, physical therapy can both decrease overall health care utilization and save money down the road—especially if delivered sooner rather than later. These were the takeaways from 2 articles in a May 2018 special issue on nonpharmacological management of pain published by PTJ (Physical Therapy), APTA’s scientific journal. PTJ Editor-in-Chief Alan Jette, PT, PhD, FAPTA, interviewed authors of each of the studies via podcast.

One study, coauthored by Xinliang “Albert” Liu, PhD, examined the effect of timing of physical therapy on downstream health care use and costs for patients with acute low back pain (LBP) in New York state. The patients were categorized by whether and how soon they received physical therapy after seeing a physician for LBP: at 3 days, 4–14 days, 15–28 days, 29–90 days, and no physical therapy. Patients who received physical therapy within 3 days (30%) incurred the lowest costs and utilization rates, while those who didn’t see a PT at all saw the greatest of both.

Full story at APTA