Opioid painkillers don’t help patients move

While the dangers of addiction have led healthcare providers to take a hard look at their prescribing practices, there’s another potential downside to using opioids to treat pain. Opioid therapy for neuropathic pain does not appear to help patients restore physical function, according to a new study published in Pain Medicine.

“Pain is very complex, and people experience pain at very different levels,” Geoff Bostick, Ph.D., associate professor of physical therapy at the Faculty of Rehabilitation Medicine and lead author of the study, said in an announcement. “Opioids can help people with severe pain be more comfortable, but if they are not also facilitating improved function, the impact of these medications on quality of life should be questioned.”

The study involved 789 patients across Canada who provided baseline measures of self-reported function, and again at six and 12 months after treatment. Complete data was available for 535 patients. Adjusting for severity of the symptoms, the team found that physical functioning and disability did not improve in patients with neuropathic pain who were prescribed opioids compared with those who were not prescribed.

To help patients with pain improve their mobility, Bostick, a physiotherapist, recommended a graded approach. For example, once patients with chronic pain are medically cleared for physical activity, providers should encourage them to walk until they are at 50 percent of their pain tolerance, and push their limits gradually each week. With this method, patients’ tolerance and mobility should gradually increase, he said.

And while opioids may play an important role in managing some patients’ pain, they may work better in conjunction with other therapies, such as physical therapy, Michael W. Smith, M.D., medical director and chief medical editor at WebMD said.  However, Smith also acknowledged that physicians need better training about how to treat pain. “What doctors need absolutely is education around when to use them [opioids], when to prescribe them and, honestly, probably most importantly, how to talk to patients and have them be happy with alternatives,” he said.