A new study out from (The Workers’ Compensation Bureau Insurance Rating Bureau of California) WCIRB called “Physical Medicine Treatments and Their Impact on Opioid Use and Lost Time in California Workers’ Compensation” shows that as physical medicine utilization increases, opioid utilization decreases.

Physical therapy, acupuncture and chiropractic care are consistently corresponding with lower opioid prescription use in workers’ comp. Physical medicine payments per claim have increased 8 percent annually, with utilization increasing at the same rate, while utilization of opioids and other pain medications decreased by 86 percent between 2013 and 2018 for claims involving physical medicine.

The average medical payment for physical medicine rose from 2013 to 2018, contributing to a growing proportion of the total medical paid per claim (8 to 11 percent) as well as the medical paid for physician services per claim (16 to 25 percent). This was mostly due to changes in fee schedule and billing of most frequently used procedures codes, as well as a slight shift in the service mix.

Soft tissue injury claims involving PT during the first 30 days of the initial medical visit were less likely to initiate opioid use within one year of the injury, compared to similar claims without early PT. The impact of early PT on initiation of opioid use varies over time, for example before 2015 soft tissue injury claims involving early PT did not have a lower risk of opioid use within one year of the injury, but between 2015 and 2017 soft tissue claims involving early PT were significantly less likely to involve opioid use – by about 14 percent on average.

Among soft tissue injury claims that had at least one opioid prescription within one year of the injury, those with early PT had, on average, significantly lower doses of opioids prescribed, by 23%, than similar claims without early PT. In comparing claims of similar characteristics but with different timing of utilizing PT, those with early PT had significantly lower odds of having lost time, by 12%.

Read the full study from WCIRB here and read more here.