An Innovative Physical Therapy Intervention for Chronic Pain Management and Opioid Reduction among People Living with HIV

• Type of Material: Article
• Authors: Sara Pullen, Emory University; Carlos del Rio, Emory University; Carlos Del Rio, Emory University School of Medicine; Daniel Brandon, Emory University School of Medicine; Ann Colonna, Emory University School of Medicine; Meredith Denton, Emory University School of Medicine; Matthew Ina, Emory University School of Medicine; Grace Lancaster, Emory University School of Medicine; Anne-Grace Schmidtke, Emory University School of Medicine; Vincent Marconi, Emory University
• Language: English
• Date: 2020-12-01
• Publisher: Mary Ann Liebert, Inc.
• Publication Version: Final Published Version
• Copyright Statement: © Sara D. Pullen et al. 2020.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1089/biores.2020.0006
• Title of Journal or Parent Work: BioResearch Open Access
• Volume: 9
• Issue: 1
• Start Page: 279
• End Page: 285
• Grant/Funding Information: This study received support from the National Institutes of Health Emory University Center for AIDS Research (P30AI050409) and the National Institutes of Health National Institute on Drug Abuse (L30 DA046878).
• Keywords: physical therapy; opioids; chronic pain
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Chronic pain management has become a treatment priority for people living with HIV (PLH), and PLH may be at increased risk for opioid addiction. Physical therapy (PT) has been shown to be effective as a nonpharmacological method of chronic pain management; however, there is a gap in research examining the role of PT for chronic pain, especially as it relates to opioid reduction, in this patient population. This retrospective study evaluated pain level and opioid use before and after PT intervention among HIV-positive adults with chronic pain on chronic opioid therapy (n = 22). The study was conducted at a multidisciplinary AIDS clinic in Atlanta, GA. Outcome measures were self-reported pain on the numerical rating scale (0-10) and morphine milligram equivalents (MMEs), which measure opioid use. A majority of patients (77%) demonstrated a decrease in pain by the conclusion of the study period; however, only 18.2% of patients reported decreased pain as well as a decrease in MMEs. The most common PT treatments used among the patients with a decrease in pain and/or opioid use included home exercise programs, manual therapy, and self-pain management education. Eighty percent of the participants who did not decrease opioid use reported a decrease or elimination of pain by the end of the PT intervention. This reflects the need for careful consideration of the complexity of opioid use and addiction, and the importance of a multidisciplinary team to best serve the needs of PLH aiming to decrease chronic pain and opioid use.