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Opioids vs Physical Therapy

According to the Centers for Disease Control and Prevention (CDC), “The amount of painkillers, such as oxycodone and hydrocodone sold in the United States, has nearly quadrupled since 1999”, even though “there has not been an overall change in the amount of pain that Americans report.” As of 2014, the CDC estimates that 52 people die each day in the United States due to prescription opioid overdose. In 2012, health care providers wrote 259 million prescriptions for opioid pain medication. That is enough for every American adult to have their own bottle of pills. More than 165,000 people in the United States have died from opioid pain-medication-related overdoses since 1999, and every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids. Opioids can affect anyone, young and old, rich and poor, athletes, family, friends, and neighbors.

In response to the growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. These guidelines recognize that in some situations, prescription opioids are appropriate when properly dosed and closely monitored. Some such instances include cancer treatment, palliative, and end-of-life care, and certain acute care situations. However, for many, opioids are not the right choice, and the CDC is strongly recommending non-opioid approaches, such as Physical Therapy and exercise.

Patients should choose Physical Therapy when…

The risks of opioid use outweigh the rewards

The potential side effects of opioids include depression, overdose, addiction, and withdrawal symptoms when stopping opioid use and heroin use. People addicted to prescription opioids are 40 times more likely to be addicted to heroin. Because of these risks, “experts agreed that opioids should not be considered first-line or routine therapy for chronic pain,” the CDC guidelines state. Non-opioid treatment plans have much lower risks.

Patients want to do more than mask the pain

For some, opioids may reduce the sensation of pain, but they do not fix the cause of the problem. Physical therapists treat pain through movement and re-establish normal movement patterns with improved strength, mobility, and neuromuscular control. The CDC cites “high-quality evidence” supporting exercise, along with weight loss, if needed, as part of a physical therapy treatment plan for common complaints such as low back pain, neck pain, hip and knee osteoarthritis, and fibromyalgia.

Opioids are prescribed for pain

If and 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. We hear too often, “take a painkiller before Physical Therapy, so you feel better.” It should be “let’s move and exercise to make our own natural pain relief.” “Motion is Lotion,” and actually getting the muscles and joints moving can help flush out the inflammatory chemicals within your cells and helps stimulate the brain to make its own natural anti-inflammatories and natural endorphin painkillers that are far more effective than synthetic tablets.

The Pain Lasts 90 Says

When pain lasts longer than 90 days, it is considered “chronic,” risks for continued opioid use also increase. An estimated 116 million Americans report chronic pain each year. The CDC guidelines note that non-opioid therapies are “preferred” for chronic pain and that clinicians should consider opioid therapies only if expected benefits for both pain and function are anticipated to outweigh risks to the patient

The choice is yours. Before you agree to a prescription for opioids, you should ask your doctor if any non-opioid treatment options such as Physical Therapy can help. In the state of New Jersey, Physical Therapists are Direct Access Clinicians, meaning that unless you have Medicare, Workers Compensation, or Motor Vehicle injury, you can come and get evaluated by a Physical Therapist without a prescription. Our physical therapists here at Forward Motion Physical Therapy are educated on pain neuroscience, movement assessment, and exercise prescription to allow us to set realistic goals and expectations for you. Call Forward Motion Physical Therapy and talk to one of our physical therapists to discuss the options for a non-opioid treatment.

5 Tips to Avoid Chronic Pain

1. Know Pain, Know Gain.
   Evidence suggests that understanding how our pain systems work is an excellent strategy in managing it. The great news is that you don’t need to know a lot! Simply learning the basics of how our brain and nerves work and their role in pain can help reduce your chance of developing chronic symptoms. When we understand what pain is, we can use it to guide our movements and activities better.
2. Keep moving.
   Our body was built to move. Living an active, healthy lifestyle improves our general well-being and health and can also reduce our chances of developing chronic pain. Listening, knowing, and understanding that not all aches, pains, or soreness cause concern. We need this feedback. It is our body’s way of letting us know how it responds to the demands we are placing on it.
3. Spend time with a good PT.
   If you experience an injury or develop the onset of pain, seeing a physical therapist can help address and manage your symptoms before they become a bigger problem. PTs are movement experts. We can diagnose and treat injuries and help you identify different strategies and exercises to manage your pain better. The earlier you seek care, the better the chances you have of not developing chronic symptoms. There’s no reason to wait: you can see a physical therapist without a physician’s referral.
4. Don’t focus on an image.
   Most of us want a diagnostic image to tell us “why we hurt.” Images give us little information about what’s causing pain. What shows up on an image may or may not be related to your symptoms. Once imaging has cleared you of a serious condition, your physical therapist will help guide you back to the life you want to live! A study performed on individuals 60 years or older, with no symptoms of low back pain, found that more than 90% had a degenerated or bulging disc, 36% had a herniated disc, and 21% had spinal stenosis.
5. Addressing depression and anxiety helps
   Your chances of developing chronic pain may be higher if you also are experiencing depression and anxiety. The more you understand your pain and treatment options, the easier it’ll be to get you back on your feet. A study in the Journal of Pain showed that depression and some thoughts and feelings about pain before total knee replacement were related to long-term pain following the procedure.

Another example you may be able to relate to is – if you’ve had a long and stressful day. You hit traffic on your commute, you come home, and the kids have made a mess. The floor is littered with book bags, the sink is full of dishes, and your neck, back or knee pain may feel like a 10/10. Compare this to the day before, when your pain was only 2/10, the kids had done their homework without any arguments, the dishes made it into the dishwasher, and clothes and book bags were put away.

Daily stressors affect how we experience pain. Make sure that you talk to your medical provider and physical therapist about your mental health throughout your treatment; it can help make your journey go much more smoothly following an injury or surgery.

A Safe Alternative to Opioids for Pain Management

The opioid epidemic doesn’t discriminate. Opioid and heroin use has increased significantly across most demographic groups. “As many as 1 in 4 people who receive prescription opioids long-term for non-cancer pain in primary care settings struggles with addiction,” the CDC cites. Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids. Since 1999, more than 165,000 people in the United States have died from opioid pain medication-related overdoses.

People experiencing pain can learn more about the benefits of physical therapy as a safe, effective alternative to opioids by calling Forward Motion Physical Therapy today at 973.400.3730 or by clicking here.