No More Opioids! Go to Physical Therapy! By: Kelsey VanVolkenburg, PT, DPT
The opioid epidemic continues to get worse and worse, and you are commonly hearing about it in the news. The CDC reports that the sales of opioids have quadrupled however there has not been a change in the amount of pain that Americans have.¹ Just in 2012, there were 259 million opioid prescriptions written by health care providers, and to put that in perspective, it is enough for every adult in the US to have their own bottle of pills.² The problem with this is that it leads to opioid abuse and further leads to addiction. The CDC reported that in 2014 there were more deaths from drug overdoses than any prior year and at least of those deaths involved prescription opioids.² Also, those that are addicted to prescription opioids are also 40 times more likely to become addicted to heroin at some point in their life.²
So what exactly is the alternative to taking opioids for pain relief?..... PHYSICAL THERAPY!
When do you know it is okay to choose physical therapy instead of medications?¹
The risks of opioid use outweighs the rewards
Patients want to do more than just mask the pain
Pain is related to low back pain, hip or knee osteoarthritis or fibromyalgia
Pain lasts 90 days or more (to prevent opioid dependency)
Call your physical therapist and your PCP for more information. (physical therapists are not pharmacists however we can direct you in the right direction)
The CDC quoted in 2016:
“Nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred for chronic pain. The contextual evidence review found that many nonpharmacologic therapies, including physical therapy, weight loss for knee osteoarthritis, psychological therapies such as cognitive behavioral therapy, and certain interventional procedures can ameliorate pain.”²
Physical therapists are considered movement experts, and are trained to treat pain through movement instead of masking the pain.² With this type of treatment, the body is being helped to restore function and relieve the pain.³ Opioid use actually triggers extreme sensitivity in the pain receptors and this can make pain worse over time. Couple this with not performing exercises or being sedentary, now you have increased pain and limited function.³ This is why movement is so important. Some patients one week post surgery may need initial medication, however this coupled with physical therapy will help with their pain relief and get them to stop taking the pain medications quicker.
The first step that a physical therapist will take is to identify the cause of the patient’s pain and then set functional goals for that patient. They will then develop a treatment plan specific to that patient’s needs and goals that will deal specifically with their pain contributors. This may involve a combination of therapeutic exercises, manual therapy, modalities and education on neuroscience and the reasoning behind pain. The sooner a patient starts physical therapy, the more likely it is that they will not misuse opioids. Physical therapists work very closely with other health care professionals such as surgeons, physicians and even pain specialists, so it is easier to get these patients to physical therapy in a quick manner.4 Also, most patients are able to be seen without a doctor’s referral, this is called direct access. You can contact our office to see if you are eligible to be seen without a referral.
With the collaboration of doctors, physical therapists and patients, we can help to stop this opioid epidemic and get these people that are in pain back to a more normal and functional lifestyle with less pain and without opioids!
For more information on safe pain management and utilizing physical therapy to fight the opioid epidemic, access the APTA’s website and search Safe Pain Management at: https://www.apta.org/advocacy/issues/opioid-epidemic-safe-pain-management
References:
Physical Therapy vs. Opioids: When to Choose Physical Therapy for Pain Management. Choose PT. 2020. https://www.choosept.com/resources/detail/physical-therapy-vs-opioids-when-to-choose-physica
Opioid Abuse and the Role of Physical Therapy. APTA. 2017. https://cdn.ymaws.com/www.kpta.org/resource/resmgr/legislative/2017_Legislative_Day/PositionPaper_Opioids.pdf
3. Physical Therapy Can Help You Leave the Pain Relievers Behind. Elliott Physical Therapy. 2020.
4. Using Physical Therapy to Battle the Pain Killer Crisis. ProRehab. 2019.
https://www.prorehab-pc.com/2019/09/physical-therapy-treats-pain-killer-abuse/