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ALEXANDRIA, VA, June 29, 2017 — An interdisciplinary team of researchers at the University of Pittsburgh reports that rehabilitation, including physical therapy, provided within 1-15 days of pain beginning may significantly reduce the use of opioids, nonsurgical invasive procedures such as joint injections, and surgery in patients with nontraumatic knee pain.
The authors examined data from a sample of 52,504 Medicare beneficiaries with nontraumatic knee pain for 12 months. The study's findings, published in the June issue of the American Physical Therapy Association's (APTA) scientific journal, Physical Therapy (PTJ), suggest that rehabilitation is most effective when it's provided earlier in the course of a patient's care.
Although evidence-based clinical guidelines recommend patients be prescribed therapeutic exercise as a first-line treatment for nontraumatic knee pain, the researchers found that only 11% of the total number of beneficiaries received these services.
Of the 8,672 patients who received rehabilitation for nontraumatic knee pain, more than a third were limited to postsurgical care only. For the remaining 5,852 patients, most (52%) were exposed to early rehabilitation (provided within 1-15 days).
Rehabilitation included exercise and other nonpharmacologic services or procedures—such as nutritional counseling, functional training, physical agents, manipulation, and manual therapy—regardless of type of provider or setting.
"We were surprised to find a low percentage of patients received outpatient rehabilitation for their knee pain," said lead author Joel M. Stevans, DC, PhD. "Our research further emphasizes the importance of working with colleagues from other disciplines to better understand how patients can be directed."
Increased and more immediate use of rehabilitation services could decrease the use of opioids or more invasive procedures, like surgery.
"We believe this will help reduce utilization of health care services that are more invasive or may place patients at greater risk," said study coauthor G. Kelley Fitzgerald, PT, PhD.
Physical therapy is among the nonopioid alternatives recommended in a March 2016 guideline issued by the Centers for Disease Control and Prevention (CDC), urging health care providers to reduce the use of opioids for most long-term pain management.
"Physical therapists help patients reduce or eliminate pain through movement and exercise," said APTA President Sharon Dunn, PT, PhD, Board-Certified Orthopaedic Clinical Specialist. "This study adds to a growing body of evidence supporting nonpharmacological treatment options like physical therapy for chronic pain conditions."
Knee pain can occur suddenly or develop slowly over time and in different parts of the knee. Physical therapist treatment includes a thorough examination and an active plan of care, personalized to a patient's goals.
The American Physical Therapy Association represents more than 95,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide. Visit MoveForwardPT.com to learn more about the types of conditions physical therapists treat and find a physical therapist in your area.