The Many Ways to Treat Pain

The two articles I wanted to highlight this week revolve around a common theme in the healthcare industry – treating pain. The first article discusses a potential new replacement for opioids. The second is an interesting study examining how physical therapy effects the treatment of low back pain. Below you’ll find these articles and my thoughts on their implications.

Disclaimer: The views and opinions expressed below are those of Mark Pew, Senior Vice President of Product Development and Marketing, and do not necessarily reflect the views of Preferred Medical.

Nonaddictive Drug Compound Could Replace Opioids for Chronic Pain Sufferers

A research team at Purdue University has just discovered a new non-addictive drug compound that has the potential to be used to treat chronic pain. With the opioid epidemic being a huge issue across the U.S. this discovery could be huge. This compound has the potential to treat chronic pain directly or patients can use it to reduce the side effects of opioids.

Mark’s Thoughts:
Lots of people are trying to find the #opioid antidote (not naloxone but treatment options instead of). This particular compound seems somewhat theoretical/academic at this point – doesn’t mention any kind of trials – but exemplifies the ongoing quest for tools to manage #ChronicPain. Some will succeed, some will fail, but there is a lot of effort towards adding tools in the toolbox for providers and patients. This compound discovered at the Purdue University’s College of Pharmacy shows “unparalleled selectivity in inhibiting the adenylyl cyclase 1 (AC1, an important biological messenger in numerous organisms including the communication of pain in the body), making it a potential target for treating pain and reducing the dependency on opioids for pain management.” Whether it’s this compound, or non-pharmacological treatment options (you know the list), building resilience with individualized coping mechanisms is part of the answer to the issues of managing chronic pain and the over-prescribing of painkillers.

Physical Therapy as First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization and Costs

This study examines the difference in individuals with low back pain who saw a physical therapist at the first point of care for low back pain, anytime during their pain or not at all. Some key findings were that patients who saw a physical therapist first had a lower probability of receiving an opioid prescription, advanced imaging, and emergency department visits. Additionally, patients who saw a physical therapist first payed less out of pocket.

Mark’s Thoughts:
“Patients (with low back pain) who saw a PT first had lower probability of having an opioid prescription (89.4 percent)”…That’s because Active > Passive. Take 30 seconds, read this abstract, and tell me why Payers sometimes object to physical therapy. I know it doesn’t work for everybody and for every condition, but instilling hard caps on its use – universally without any consideration for individual responses – seems…um…how do I say this nicely…counter-productive? The goal is to move engaged patients into active treatment as quickly as possible to take them closer to self-management.

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Until next week,