Brian T. Swanson
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The National Survey on Drug Use and Health (NSDUH) reported that an estimated 27 million people in the United States have reported use of an illicit drug within the past month. Low back pain continues to be a major cause of disability in the United States, with an estimated 70 percent of adults experiencing low back pain at some point during their lifetime. Active exercise programs that include pain education and cognitive behavioral therapy demonstrated significant superior outcome at reducing pain intensity, anxiety/depression, disability, and fear-avoidance compared to therapeutic exercise and manual therapy alone for patients with non-specific chronic low back pain. With both illicit and prescription drug use rising in the US, it is likely clinicians will encounter patients with substance abuse disorders, as well as opiate induced hyperalgesia. The use of psychologically informed practice may be beneficial in this patient population. There is ample research on various approaches to treating low back pain, however there is limited research investigating the efficacy of treatment for patients with low back pain and a previous history of opioid dependency. The purpose of this case report was to describe the physical therapy treatment, including pain management strategies, for a patient with low back pain, a previous history of opioid dependency (oxycodone), and apparent opiate induced hyperalgesia.
Alomar, Marcus X. and Swanson, Brian T., "Physical Therapy Treatment Of A Patient With Chronic Low Back Pain And A Previous History Of A Substance Abuse Disorder: A Case Report" (2016). Case Report Posters. Poster 103.