Weigh Your Options

Physical therapy vs. opioids in treating chronic pain

By: Leticia Morales

Many of us have experienced the nuisance of a minor pain. If allergies cause a sinus headache, a decongestant can help. If you have an aching back from a weekend spend doing yard work, ibuprofen may do the trick. But what about those who suffer from chronic pain that lasts longer than six months?

No one wants to live in pain, but we also have to be careful not to put our health at risk to be pain-free. When used properly, certain drugs – such as opioids – can help relieve pain. But they can be dangerous if misused or abused.

Americans have increasingly been prescribed opioids like Vicodin, OxyContin, Opana and methadone, as well as combination drugs like Percocet, to help relieve pain. The use of these prescription drugs has quadrupled since 1999, although there hasn’t been an increase in the amount of pain Americans report.

In 2012, health care providers wrote 259 million opioid prescriptions, enough for every adult in the United States to have a bottle of pills. According to data collected by the Centers for Disease Control and Prevention (CDC), as many as one in four people who receive prescription opioids long-term for non-cancer pain in a primary care center struggles with addiction.

When taken as directed, opioids can manage pain effectively for a short amount of time. But with long-term use, there is a possibility it can lead to physical dependence or even an addiction disorder. Along with addiction, opioid risks include depression, overdose and withdrawal symptoms when usage is stopped.

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines last year recognizing that opioids are appropriate in certain cases such as cancer treatment, palliative care and end-of-life care, as well as in certain acute care situations – if properly dosed. But for other pain management, the CDC recommends non-opioid alternatives such as physical therapy to cope with chronic pain.

Physical therapy is a safe and effective way to treat long-term pain. Physical therapists can provide evidence-based treatments that help treat not only the pain, but the underlying cause of the pain. They can play a valuable role in educating patients about alternative options and setting realistic expectations for recovery without opioids.

While it may feel counterintuitive, the more a person who has chronic pain moves, the better he or she usually will feel. One of the goals of physical therapy is to help patients suffering with chronic pain become stronger because they’re usually weak from lack of movement. A physical therapist will work with a patient – typically as part of a medical team – to understand the pain and what’s causing it. This allows the therapist to determine how best to treat and manage it.

Physical therapy can help decrease pain, increase mobility and improve overall mood. There are a number of ways that a therapist may help a patient manage pain. These can include low-impact aerobics, massage, stretching, use of modalities such as ultrasound and electrical stimulation, strengthening exercises, movement therapy and other types of exercises depending upon individual abilities.

Therapeutic treatments are designed to help a person increase muscle strength, endurance, joint stability and flexibility. In addition, physical therapy aids in reducing inflammation, stiffness and soreness. It encourages the body to heal itself by boosting the production of the body’s natural pain-relieving chemicals.

Overall, when it comes to chronic pain, physical therapists often can help people move safely and functionally in ways they haven’t been able to for a while. So in my opinion, it’s wise to consult with your physician to discuss your options for a non-opioid treatment before agreeing to an opioid prescription for chronic pain.

Leticia Morales is director of therapy operations at Corpus Christi Rehabilitation Hospital. The hospital provides specialized rehabilitative care to patients recovering from disabilities caused by injuries, illnesses or chronic medical conditions. It is certified nationally by the Joint Commission for Stroke Rehabilitation. For more information, visit www.ccrh.ernesthealth.com, call 361-906-3700 or visit the hospital at 5726 Esplanade Drive in Corpus Christi, Texas.

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