Physical Therapy vs Opioids

According to Lori Walters, Director of Rehabilitation Services & Diagnostic Imagery at McLaren-Flint, there have been many advancements in the field of physical therapy and one of those advancements is the use of physical therapy for chronic pain management instead of prescription painkillers.

“There is an opioid crisis in America,” Walters reports. In 2016, with the overuse of opioids for chronic pain becoming a national public health epidemic, the Centers for Disease Control and Prevention (CDC) released guidelines that recommended non-drug approaches, such as physical therapy (PT), be considered over long-term or high-dosage use of addictive prescription painkillers. According to Walters, there are many side effects that come along with the use of opioids, including: depression, overdose, addiction and withdrawal that puts a patient’s whole health at risk. And when the risks outweigh the benefits, it is recommended a patient try other forms of treatment first.

Chronic pain is defined as pain that lasts longer than three months. “Pain is a sign that something is wrong,” explains Walters. “A pain pill doesn’t treat the pain; the pain is still there. No one wants to live in pain but no one should put their health at risk in an effort to be pain free.”

PT has been determined more effective than opioids in the treatment of chronic back, neck and knee pain, and arthritis in general. “Opioids mask the pain and physical therapy treats the pain,” says Walters. “There are so many things we can do to treat the pain if we can identify the underlying root cause.”

What are the downsides of PT when it comes to treating pain? “There are none,” Walters reports. “With physical therapy, mobility improves. The patient has increased independence with decreased pain and it also helps the prevention of other health problems.”

Physical therapists use many techniques when treating pain, including exercise, manual hands-on treatment of the soft tissue, and education. Physical therapists see the patient on a consistent basis, eight to 12 visits, three times per week, and can educate the patient about caring for their pain when they return to home life or work. The therapists also work closely with primary doctors and behavioral specialists. “We work with the whole team,” says Walters. “Chronic pain requires a whole team approach.”

People who suffer from chronic pain are becoming more aware of the risks of using opioids. “There is an increased awareness, overall,” Walters shares. “People are learning that they have a choice.” As people become more active in their health care decisions, they want the pain to go away completely. “They are willing choose a safer option,” she adds.

However, there are situations when opioids are the appropriate course of treatment, such as pain caused by cancer and when a patient is undergoing palliative or hospice care. Even following surgery or a severe accident, there are other non-opioid choices for pain treatment. “The risk of becoming addicted or overdosing can often be too great,” Walters says.

There have been other advancements in the field of PT, Dr. Walters reports. As in many other sectors of the health care industry, technology, such as the use of iPads in therapy and virtual reality, is currently being utilized to advance effectiveness and understanding. The next big thing in the world of PT is Telehealth, which is something Dr. Walters is excited about. “It’s not here yet, but it’s on the horizon!”