Associations between chronic pain, analgesic use and physical therapy among adults living with HIV in Atlanta, Georgia: a retrospective cohort study

ABSTRACT

Chronic pain – widely classified as pain lasting longer than 3 months – has emerged as a treatment priority among people living with HIV (PLHIV), and has been associated with decreased patient retention in HIV primary care. This retrospective cohort study evaluated the changes in self-reported pain scores and analgesic usage for HIV-positive adults with chronic pain enrolled at a large, urban HIV clinic in Atlanta, Georgia, USA who received a physical therapy (PT) intervention compared with a demographically matched cohort who did not receive PT. Retrospective data was collected from patients’ charts who received PT, and from patients’ charts who did not receive PT during the time period. Patients who had received PT were referred by their primary HIV providers at the clinic, but were not recruited specifically for study purposes. Results revealed that among patients who received PT interventions, the majority (93.5%) reported a decrease or total elimination of pain. In addition, all of the patients who received PT reported decreased analgesic use, with the exception of opioids, which remained unchanged. Among patients who did not receive PT intervention, there was an overall increase in analgesic usage in all medication categories including opioids. The majority of the non-PT group (74%) reported increased or unchanged pain over the study period. In a non-randomized sample of HIV-positive adults at one HIV clinic, PT intervention appears to be an effective, non-pharmacological method to decrease chronic pain and analgesic use in selected persons living with HIV.

KEYWORDS:

• Chronic pain
• opioids
• physical therapy
• HIV

Acknowledgements

The author would like to acknowledge the Grady Health System, the Ponce de Leon Center Infectious Disease Program (IDP), and the patients who receive care at IDP. The author wishes also to thank Cierra Crowder, DPT, MBA; Lance Frank, DPT; Rebecca Hayes, DPT; Alex Johnson, DPT; Leanna Racine, DPT; Brooke Zeluff, DPT for their work on this project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Support for this work was provided by the National Institutes of Health, National Institute on Drug Abuse under [grant number L30 DA046878]. The study also received support from the Center for AIDS Research, Emory University [grant number NIH/NIAID P30 AI050409].