Early Rehabilitation in Patients With Nontraumatic Knee Pain Significantly Linked to Lower Use of Opioids, Injections, and Knee Surgery

Researchers at the University of Pittsburgh recently reported 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, 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.

Increased and more immediate use of rehabilitation services could decrease the use of opioids or more invasive procedures, like surgery.

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.