Physical therapy and opioid use for musculoskeletal pain management: competitors or companions?
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Musculoskeletal (MSK) pain conditions are highly prevalent and a leading cause of disability globally. When people with MSK pain seek health care, they often receive treatment not aligned with best practices, including initial management options such as opioids. In recent practice guidelines, nonpharmacological treatments have been emphasized for initial pain management, and physical therapists are providers who routinely deliver nonpharmacological treatments. The purpose of this review is to describe the current and future state for how physical therapy may be used to increase exposure to nonpharmacological treatments for MSK pain conditions. For the current state, we review existing observational evidence investigating early exposure to physical therapy and its influence on subsequent opioid use. For the future state, we propose clinical research questions that could define the role of physical therapy on interdisciplinary teams working towards improving effectiveness of nonpharmacological treatments through more rigorous study designs. These clinical questions are intended to guide health services research and clinical trials when building an evidence base of nonpharmacological care options for MSK pain conditions.
Published Version (Please cite this version)10.1097/pr9.0000000000000827
Publication InfoGeorge, Steven Z; & Goode, Adam P (2020). Physical therapy and opioid use for musculoskeletal pain management: competitors or companions?. Pain reports, 5(5). pp. e827. 10.1097/pr9.0000000000000827. Retrieved from https://hdl.handle.net/10161/22294.
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Steven Zachary George
Laszlo Ormandy Distinguished Professor of Orthopaedic Surgery
Dr. George’s primary interest is research involving biopsychosocial models for the prevention and treatment of chronic musculoskeletal pain disorders. His long term goals are to 1) improve accuracy for predicting who is going to develop chronic pain; and 2) identify non-pharmacological treatment options that limit the development of chronic pain conditions. Dr. George is an active member of the American Physical Therapy Association, United States Association of the Study of
Adam Payne Goode
Associate Professor in Orthopaedic Surgery
Dr. Goode is an Associate Professor in the Department of Orthopedic Surgery. He is a physical therapist by clinical training and epidemiologist by scientific training. His focus is on understanding the etiology of low back pain and other chronic musculoskeletal conditions and improving the delivery of care for patients with acute and chronic musculoskeletal conditions. In his research he has published in the areas of the relationship between individual radiographic features in the lumbar s
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