By Lisa Meyer, MBA, PT
In the past year, there has been much press about the use of opioid medications. Opioids are commonly prescribed for pain, and the Centers of Disease of Control and Prevention (CDC) estimates that sales of prescription opioids have quadrupled in the United States in the past few years. In response to this growing epidemic, the CDC released guidelines in March 2016 that indicate prescription opioids are appropriate in certain cases, including cancer treatment, palliative and end-of-life care, and in certain acute care situations, if properly dosed. On the other hand, opioid pain medication use presents serious risks, including depression, overdose and addiction/withdrawal when stopping opioid use.
There are many nonopioid approaches to pain management, including chiropractic care, holistic medicine, cognitive behavioral therapy, acupuncture, and physical therapy. According to the American Physical Therapy Association (APTA), patients should choose physical therapy when:
- Patients want to do more than mask the pain. Physical therapists can identify the cause of pain and develop movement patterns to improve function and mobility. Physical therapists also utilize various modalities, such as ultrasound and electrical stimulation, as well as soft tissue mobilization and therapeutic exercises to restore function
- Pain that is in low back or neck, is related to hip or knee osteoarthritis, or due to 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 when opioid are prescribed, the CDC recommends that patients should receive “the lowest effective dosage,” and opioids “should be combined” with nonopioid therapies, such as physical therapy.
- Pain that lasts more than 90 days. Pain for more than 90 days is considered “chronic,” and the risks for continued opioid use increase.
Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids. Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment.