Physical Therapy for Chronic Pain Mitigation and Opioid Use Reduction Among People Living with Human Immunodeficiency Virus in Atlanta, GA: A Descriptive Case Series

AIDS Res Hum Retroviruses. 2020 Aug;36(8):670-675. doi: 10.1089/AID.2020.0028. Epub 2020 Jun 2.

Abstract

People living with HIV (PLH) may be at increased risk of experiencing both chronic pain and opioid dependence. Physical therapy (PT) has been shown to be effective as a nonpharmacological strategy for mitigating chronic pain in the general population, however, there is gap in research investigating PT to reduce chronic pain and opioid use among PLH. This case series describes the feasibility of an innovative PT intervention to decrease chronic pain and opioid use at a multidisciplinary human immunodeficiency virus (HIV) clinic. Participants (n = 4) were evaluated and given an individualized PT "package" consisting of manual therapy, exercise prescription, Transcutaneous Electrical Nerve Stimulation, and pain coping strategies. Pre- and postintervention outcomes were measured for pain reports, opioid use, and quality-of-life measures. After the intervention, all participants reported decrease or total elimination of both pain measured on the 0-10 numerical rating scale and opioid use measured in morphine milligram equivalents (MME). A paired t-test showed a significant difference (<.05) in the preintervention and postintervention pain scores and MME values. Results of this case series suggest in this sample that the described PT intervention is a feasible approach to mitigating chronic pain and opioid use among PLH and should be implemented on a larger scale for maximal effect.

Keywords: HIV/AIDS; chronic pain; opioids.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Analgesics, Opioid / adverse effects
  • Chronic Pain / prevention & control
  • Chronic Pain / therapy*
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • HIV Infections / therapy*
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / prevention & control*
  • Opioid-Related Disorders / therapy
  • Physical Therapy Modalities*
  • Qualitative Research
  • Quality of Life
  • Surveys and Questionnaires

Substances

  • Analgesics, Opioid