Alternative drug-free interventions to manage pain, including acupuncture and electrotherapy, may help reduce the need for prescription painkillers after knee replacement surgery, a new review suggests.
“As prescription opioid use is under national scrutiny and because surgery has been identified as an avenue for addiction, it is important to recognize effective alternatives to standard pharmacological therapy, which remains the first option for treatment,” the study team wrote.
The finding stems from an in-depth look at 39 already-completed studies. These studies included nearly 2,400 total knee replacement patients.
The studies looked at a number of different alternative treatments, including acupuncture and electrotherapy (the use of electrical energy to stimulate nerves and muscles). The researchers also included studies of cryotherapy (involving the application of extreme cold to the surgical region), a machine-based rehabilitation regimen known as continuous passive motion, and pre-surgery exercise regimens.
The review team was led by Tina Hernandez-Boussard of Stanford University. The investigators found no evidence that either continuous passive motion or pre-operative exercise reduced pain after surgery or the need to take opioids. Cryotherapy also didn’t appear to help curtail pain. It was marginally linked to a drop in opioid use.
Both acupuncture and electrotherapy were “moderately” linked to effective pain control and less reliance on opioids among knee surgery patients, the findings showed.
The finding comes amid increasing concern about opioid dependence among patients suffering from chronic pain. Examples of opioids include oxycodone (OxyContin and Percocet) and hydrocodone (Vicoprofen).
Hernandez-Boussard and her colleagues outline their findings in the Aug. 16 issue of JAMA Surgery.
There’s more on knee surgery recovery at the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.