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Fixing Musculoskeletal Pain Without Addictive Opioids

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Musculoskeletal pain is the leading contributor to disability in the world, including missed days of work (WHO, 2022). Musculoskeletal pain is also the primary reason opioids are prescribed, often inappropriately. Despite well-published guidelines encouraging non-opioid treatments, 21.5% of patients are currently prescribed opioids at their initial visit for musculoskeletal (MSK) pain (Feldman, 2020). 

To say that opioids cause problems would be a gross understatement. Opioid use in the workplace, both acute and chronic, can lead to more missed days of work, difficulty finding good employees, and potentially more workplace injuries.

Every opioid prescription carries a risk of addiction. A CDC study showed that a person prescribed opioids for even one day has a six percent risk of still being on opioids at the one-year mark. That risk increases to 13.5 percent for an initial prescription duration of eight or more days and 29.9 percent for an initial prescription duration of 31 or more days (Shah, 2017). One of the easiest ways to avoid being on opioids at the one-year mark is to not start opioids in the first place. 

So, how can we treat people who are in pain from MSK conditions? At Vori Health, we follow recommended treatment guidelines and stay up to date with the current literature. We know, for example, that starting physical therapy early can reduce the need for opioids and that other non-addictive medications are equally as effective as opioids for acute MSK pain (Sun, 2018 and Shaughnessy, 2021). 

At Vori Health, we also move beyond physical therapy and non-opioid medications to improve outcomes through a holistic, biopsychosocial approach. We practice a unique Care Team model that surrounds patients with the support of an MSK specialty physician, advanced practice provider (nurse practitioner or physician associate), physical therapist, health coach, and nutritionist. 

Through this model, we emphasize the role of behavioral health and patient education—to not only inform patients about the risks of opioid use but to also deepen their understanding of the pain cycle and healing process. For example, our health coaches support patients with stress reduction, improved sleep, and mindfulness—all of which can improve pain. Our nutritionists help patients optimize their weight and adopt an anti-inflammatory diet, both of which can also reduce musculoskeletal pain.

Working together, our clinicians operate as a true team to provide coordinated care that is highly effective at addressing both acute and chronic MSK pain. Give your team a leg-up with musculoskeletal pain and injuries. Talk to us to learn more about our evidence-based, opioid-limiting MSK solutions for your employees.

KEY POINTS

  • MSK pain is the leading cause of disability in the world.
  • More than 1 in 5 patients (21.5%) are inappropriately prescribed an opioid pain medication for MSK pain at their initial visit.
  • Nearly 1 in 7 patients (13.5%) initially prescribed an opioid for 8 or more days will be on opioids at the one-year mark.
  • Vori Health breaks the connection between MSK pain and opioids through appropriate, evidence-based medical care, focused on the whole person.

REFERENCES

WHO, 2022: World Health Organization Report, https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions, accessed July 18, 2022.

Feldman, 2020: Feldman D, Carlesso L, and Nahin R. Management of Patients with a Musculoskeletal Pain Condition that is Likely Chronic: Results from a National Cross Sectional Survey. J Pain 2020;21(7-8):869-880.

Shah, 2017: Shah A, Hayes C, et al. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use – United States, 2006-2015. MMWR 2017;66(10):265-269.

Sun, 2018:  Sun E, Moshfegh J, and Rishel C. Association of Early Physical Therapy with Long-term Opioid Use Among Opioid-Naïve Patients with Musculoskeletal Pain. JAMA Netw Open 2018;1(8):e185909.

Shaughnessy, 2021: Shaughnessy A. Single-Dose Opioid Analgesics Offer No Benefit over Nonopioid Analgesia for Musculoskeletal Pain. Am Fam Physician 2021;104(1):95-96.

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