Choose Physical Therapy for Safe Pain Management
Physical therapy is a safe and effective alternative to manage pain and reduce the use of opioids. Over the last two decades, opioid prescription rates have quadrupled as opioid prescriptions have increased for post-surgery and chronic pain patients. Opioids pose a significant risk with serious side effects like depression, addiction, and possible overdose. In 2016, the CDC recommended physical therapy and prescribed exercise as a safe alternative to managing long-term pain and preventing opioid use and addiction.
The Risk of Opioids
Opioid medications, like oxycodone, hydrocodone, and morphine, can be prescribed to treat pain. In the 1990s, it became common to prescribe opioids for post-surgery patients or during cancer treatment. In the last twenty years, opioid prescriptions have increased exponentially for chronic pain conditions, such as chronic back and neck pain, fibromyalgia, and knee or hip osteoarthritis. The overprescription of opioids has contributed to a severe opioid addiction epidemic throughout the United States.
Opioids are highly addictive and the increase in opioid prescriptions has correlated to high numbers of opioid overdose-related deaths. While the opioid crisis started with the over-prescription of and addiction to legal opioid pain medications, it has since intensified with the influx of synthetic illegal opioids like heroin and fentanyl. Seventy-five percent of heroin users first abused prescription opioids. Since 1999, overdose deaths involving opioids have increased sixfold.
In 2020, nearly 70,000 people in the United States died of opioid-related overdoses, which is the highest toll on record per the CDC. The Covid-19 pandemic exacerbated this crisis with reported spikes in overdose deaths across the United States. Over 1,300 people die weekly from opioid-related overdoses and millions of Americans suffer from opioid addiction.
Physical Therapy as a Safe Alternative
In 2016, the CDC recommended the use of physical therapy as a safe and effective alternative to opioid prescriptions to manage pain. Research has shown that physical therapy is effective in managing chronic pain and is a successful alternative to surgery for many musculoskeletal conditions, e.g. meniscal tears, knee osteoarthritis, and rotator cuff tears. Exercise therapy in particular can reduce pain and improve function for those with chronic low back pain, osteoarthritis of the knee and hip, and fibromyalgia.
Opioids mask the sensation of pain by interrupting pain signals to the brain. Physical therapy, alternatively, treats pain through movement and works with patients to improve and maintain mobility and quality of life using an individualized treatment plan customized to the patient’s specific condition. For chronic pain patients, physical therapists work closely to gradually desensitize the area of chronic pain through gentle and targeted movement training to improve the patient’s overall function. While the side effects of opioids include depression, addiction, and risk of overdose, physical therapy’s “side effects” involve improved mobility, greater independence, decreased pain, and prevention of other health issues through exercise.
Early physical therapy treatment for musculoskeletal pain can lead to fewer pain patients becoming dependent on opioids. A study of thousands of patients with back, neck, knee, and shoulder pain revealed that patients who received physical therapy within 90 days of their index date (first assessment by a primary care provider) were found to limit the use of opioid medications; if opioids were used, early physical therapy patients took a smaller dosage of opioids for pain management.
While opioid prescription can be appropriate in certain cases (such as cancer, palliative care, or acute situations) when properly dosed, opioids have been overly prescribed, leading to a severe opioid addiction epidemic. Physical therapy provides an effective and safe alternative to opioids for pain management, helping chronic pain patients decrease pain and improve mobility and function.
