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Comparing Physical Therapy and Opioids

For many of us, we know the nuisance of a minor pain. If allergies cause us to have a sinus headache, we take a decongestant. Back pain from a weekend of 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.


Americans have increasingly been prescribed opioids – painkillers like Vicodin, OxyContin, Opana and methadone, and combination drugs like Percocet. 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.

Along with addiction, opioid risks include depression, overdose and withdrawal symptoms when usage is stopped.

In response to this 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, end-of-life care and 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 not only treat 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 usually he or she 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 not moving. 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 work with the patient and other health care providers to determine how best to treat and manage it.

Physical therapists can provide exercises that strategically focus on strength, flexibility, posture and body mechanics. Strengthening and stretching parts of the body that are affected by pain can decrease the 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, manipulation of joints and bones, strengthening exercises using resistance bands, movement therapy and additional types of exercise. Exercise could involve walking on a treadmill or swimming in a pool, depending upon an individual’s abilities.

These therapeutic exercises are designed to help a person increase muscle strength, endurance, joint stability and flexibility. In addition, physical therapy also 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 that they haven’t been able to for a while. So before agreeing to an opioid prescription for chronic pain, consult with your physician to discuss your options for a non-opioid treatment. QCBN


By Jessica Baugh, PT., DPT

Jessica Baugh, PT., DPT is a Physical Therapist at Mountain Valley Regional Rehabilitation Hospital in Prescott Valley. She specializes in outpatient orthopedic injuries and individuals who suffer from chronic pain. For more information, visit, call 928-759-8800, or visit the hospital at 3700 North Windsong Drive, Prescott Valley, Arizona.


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