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PHYSICAL THERAPY VS OPIOIDS: WHEN TO CHOOSE PHYSICAL THERAPY FOR PAIN MANAGEMENT

The United States Surgeon General wrote a letter to all physicians August of 2016 with the opening line, “I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic.” For decades, long-term chronic pain management was widely believed to be controlled through opioids, such as Hydrocodone, Methadone and Oxycodone. Doctor-prescribed opioids are appropriate in some cases, but new research suggests that opioids may only serve to merely mask or block the perception of pain—and opioid risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping use. In 2016 alone, opioids contributed to about 17,000 deaths, and recently, authorities are estimating that deaths in the related overdose epidemic are likely to increase by more than 70 percent.

No one wants to live in pain. But no one should put their health at risk in an effort to be pain free. When it comes to your health, you have a choice. That’s why the CDC recommends safer alternatives like physical therapy to manage chronic pain. With a proven history in combatting aches, pains and discomfort, physical therapy is becoming a viable, non-medicated solution for those in search of remedying this physical and mental agony. “There’s a significant amount of evidence to suggest that movement-based medicines, such as physical therapy, are effective in both reducing pain and improving function and quality of life,” said Don Cassano, MPT, DPT, therapist and owner of Elite Physical Therapy. For example, physical therapy is particularly helpful for patients dealing with low-back pain, hip and knee osteoarthritis, and fibromyalgia.

How can physical therapy help chronic pain? In many cases inflammation (swelling) and muscle tightness are the culprit, putting pressure on nerves and resulting in pain. Treatment by a physical therapist can resolve this pain through movement, hands-on soft tissue techniques such as massage, dry-needling and joint mobility activities including stretching and strengthening.

Not all pain can be managed by physical therapy alone, and it varies on condition. “There are times when pain medication is OK to take, in addition to physical therapy,” Cassano says. “We definitely see that in post-surgical cases, such as when a patient has a knee or hip replacement. These are cases in which opioids are effective with physical therapy.” Physical therapy encourages patients to understand their body, and actively participate in their recovery and outcome. And unlike relying on opioid medication, “it’s a safer solution,” he said.

Patients should choose physical therapy when:

  • The risks of opioid use outweigh the rewards. — Potential side effects of opioids include depression, overdose, and addiction, plus withdrawal symptoms when stopping opioid use. Because of these risks, “experts agreed that opioids should not be considered first line for chronic pain,” the CDC guidelines state.
  • Patients want to do more than mask the pain. — Opioids reduce the sensation of pain by interrupting pain signals to the brain. Physical therapists treat pain through movement while partnering with patients to improve or maintain their mobility and quality of life.
  • Pain or function problems are related to low back painhip or knee osteoarthritis, or fibromyalgia. — The CDC cites “high-quality evidence” supporting exercise as part of a physical therapy treatment plan for those familiar conditions.
  • Opioids are prescribed for pain. — Even in situations when opioids are prescribed, the CDC recommends that patients should receive “the lowest effective dosage,” and opioids “should be combined” with non-opioid therapies, such as physical therapy.
  • Pain lasts 90 days. — At this point, the pain is considered “chronic,” and the risks for continued opioid use increase. The CDC guidelines note that non-opioid therapies are “preferred” for chronic pain and that “clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient.”

Elite Physical Therapys understand their role in solving the opioid crisis and are ready to help serve the people of Cenla. For more information on physical therapy and opioid reduction contact Elite at 318-443-3311 for an evaluation today. Don’t mask the pain – choose physical therapy!

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