Physical Therapy: The Opioid Alternative

Dec 5, 2018

Vince Kame Jr.

by Vince Kame Jr.
PT, MS, ATC | Owner of the South Chandler Location

If you have been watching the news, getting updated trend notices on social media, or listening to any reporting over the recent past you would have certainly been exposed to information concerning the Opioid Crisis we are in the midst of. One thing you have likely not heard is that physical therapy can be a potential solution. Before we can discuss solutions, it’s important to understand the problem.
If you do not think this problem can affect you, let me give you some statistics.

  • There were 58 opioid prescriptions written for every 100 Americans. Although this is a slightly declining trend from years prior, the overall strength of these medicines is increasing. Therefore, there is a flat trend when you measure the prescriptions in morphine milligram equivalents (MME’s).
  • In 2016, there were 64,000 drug overdose deaths in America; 66% of these deaths were from either a prescription or illicit opioids, including heroin.
  • 80% of all heroin users first use prescription opioids (needs link).
  • The total economic burden of prescription opioid misuse in the U.S. is estimated at $78.5 billion a year.

These numbers are staggering and should make us all realize that if we are not directly affected we at least indirectly affected.
Acute Pain vs. Chronic Pain
Now for the good news: opioids are effective and safe when used for acute pain over short durations.
There is a difference between acute pain and chronic pain.
Acute pain is a result of tissue destruction – like a broken leg or pain felt immediately after surgery. Conversely, chronic pain is the result of changes in nervous sensitivity to a condition after a longer period of time.
Treatments for Chronic Pain
Chronic pain usually does not respond well to opioids, but it does to movement and exercise — two things physical therapy is known to improve.
Chronic pain tends to decrease the pain threshold. This does not mean that we become “less tough,” as this is a physical phenomenon. Exercise tends to improve this threshold.
In a post on WebMD, Gina Shaw showed that people who exercised were better able to manage their pain versus a group who did not exercise.
Additionally, in the 2008 Nord-Trondelov study, there were significantly fewer incidents of musculoskeletal complaints for those that exercised regularly versus those who did not in an 11-year follow up.
In “Beyond Opioids: How Physical Therapy can Transform Pain Management to Improve Health,” the author notes that chronic pain is best managed when the specific pain characteristics, pain intensity, and other risk factors are taken into account.
Physical therapy is uniquely tailored to do just that.
Physical Therapy for Pain
As physical therapists, we make sure that we assess the type of pain you have as well as the intensity of the pain. We take into account what you can and cannot do because of pain and look at what you want to do if the pain was not stopping you. We then are able to come up with an exercise and movement plan to address each aspect.
Ambrose and Golightly found in a 2016 study that pain was most reduced when the exercise program was tailored individually, progressed slowly, and took into account physical limitations, psychological needs, and available resources. This is basically the definition of what we do as physical therapists.
The evidence is so strong for physical therapy and the consequences so great for overprescribing opioids that the CDC is now recommending non-opioid treatment of chronic pain and is recommending a big push for physical therapy.
Pain, specifically chronic pain, is a big problem both for the individual and as a society as a whole.
There is an alternative to medication that can cause effects worse than the pain. Movement, exercise, and physical therapy can help lessen pain. Pain, and specifically chronic pain, is not at the mercy of prescription opioids.
Physical therapy can be the answer to chronic pain without the dangers of opioids. Think movement and not medicine to gain control over how you are managing your own pain. Request an appointment with us and we’ll help you get back to the things you love.
Sources: August 2018
National Institutes of Health,  March 2018
Shaw, Gina: webMD 2018
Nord-Trondelov: BMC Musculoskeletal Discord: 2008
Beyond Opioids: How Physical Therapy Can Transform Pain Management to Improve Health:  APTA, 2018
Ambrose, KA; Golightly, YM, Physical Exercise as Non-Phamalogical Treatment of Chronic Pain. Best Practices RES. Clinical Pharmacology. February 2017

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