Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen and Naproxen are quite common in the treatment of pain, but there are some risks associated with consistent use. They are quite helpful at reducing inflammation, but when used all the time they can lead to delays in soft tissue and bone healing, increased risk of renal and liver toxicity, hemorrhages, ulcers, and effects on the central nervous system. It has been found that use of NSAIDs in conjunction with physical therapy together can be a beneficial, allowing patients to stop using the medicine more quickly. In addition, there is mounting evidence that exercise and physical activity have anti-inflammatory benefits, which are often assigned during the course of therapy.
Research also shows that physical therapy has become an effective alternative to injections. Again, steroid injections are a more costly option than physical therapy, and with these injections patients are visiting the doctor more and requesting extra injections 60% of the time. These injections may not last as long, and are not necessarily treating the root of the problem, leading to more treatments. Physical therapy involves more contact with the patient and incorporates both pain relieving modalities and an exercise program for home, treating the actual cause of pain.
Less Referrals for Opioids
As the opioid addiction epidemic continues to spread through the United States, there is an increased need for natural methods of treating pain. Physical therapy is a frontrunner for this movement as DPTs treat pain conditions using methods like electric stimulation, massage, light therapy, ultrasound, or hot and cold packs. They also focus on stretching and range of motion exercises to alleviate the pain and restore function, instead of masking the pain a patient is experiencing with opioid medication.
As the use of opioids increases for pain management in America, we face an ongoing national epidemic with more and more people becoming dependent on these drugs. Since 1999 the rate of opioid prescriptions has quadrupled, leading to similar increases in opioid and heroin overdoses. With patients only showing 30% relief of pain through opioid use, it is surprising to see the explosion in prescriptions.
In response to this growing epidemic, the Centers for Disease Control and Prevention (CDC) have released guidelines urging prescribers to reduce their use of opioids in favor of safer alternatives. Physical therapy is one of the main options on their list of alternatives to treat chronic pain.
One of the biggest issues with opioid treatment is that only masks the sensation of pain. The actual cause of the pain is not being treated, and as the effect of the drug fades the pain returns immediately. This leads to patients becoming increasingly reliant on use of opioids, making it difficult for them to break their habit of use. Physical therapists help treat the pain through movement, increasing the effectiveness as treatment continues.
With any prescription medication there is a chance for side effects. For opioids these include sedation, dizziness, nausea, depression, constipation, respiratory depression, and of course physical dependence which can lead to overdose. The effectiveness of opioids as long-term pain management has been inconclusive, and is starting to become regarded as an inadequate pain management technique. Physical therapy does not pose such side effects, and continued treatment through PT can improve mobility, increase independence, decrease pain, as well as improve strength and endurance.
With the CDC citing evidence supporting exercise as an integral part of treatment for low back pain, arthritis, and fibromyalgia, and direct access laws in place, the stage is set for physical therapy to strike a mighty blow against opioid dependence. Physical therapists, empowered by further education and improved technical diagnostic skills, are now well positioned to become the primary provider for these pain patients.
If you or anyone you know is struggling with opioid dependence, please don’t hesitate to ask for help. There are many professionals trained to aid with this issue and direct you to the appropriate course of care. When treating your pain, always remember to investigate your safest options.
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