Can physical therapy control pain as well as drugs?
It is estimated that there are roughly 100 million Americans in chronic pain, each and every day. So far, the 21st century answer for pain has been to prescribe opioids. These painkillers come with recognizable names like Vicodin, OxyContin, Opana, Methodone and combination drugs like Percocet. What has also become all too familiar is the epidemic of addiction leading to depression and deaths due to overdose that have resulted.
According to the CDC (Centers for Disease Control and Prevention) prescription sales of opioids have quadrupled in the United States and, since 1999, opioid-related deaths have skyrocketed. Some of those prescriptions may be questionable but a good many are genuine attempts to treat chronic pain. In certain cases, like cancer patients, palliative and hospice care and other extreme-care situations, prescription opioids are appropriate and very effective. For too many others, however, the trade-off for reducing pain has been devastating. The CDC and other professional medical organizations are advocating other, and often more effective, alternatives, such as physical therapy.
Why Choose Physical Therapy Over Opioids?
- Opioids only mask the pain but physical therapy treats pain through movement, increasing muscle strength, flexibility, and overall pain relief.
- Physical therapy incorporates exercise and studies have shown that regular exercise decreases pain by nearly 30 percent.
- Physical therapy is cost effective.
- There is no evidence that relief provided by opioids for chronic low back pain, hip or knee osteoarthritis, or fibromyalgia is anything more than modest and short term, which does not justify the risk. In fact, the New York Times reported that opioids “relieved pain slightly, but the effects were not clinically significant, and the medicines did little to improve disability. There was some evidence that larger doses worked better, but most trials had high dropout rates, some up to 75%, because of adverse side effects or inefficacy.”
- Physical therapy increases quality of life.
- The risks associated with opioid use far outweighs the potential benefits.
As stated in the guidelines published by the CDC, alternatives, like physical therapy are recommended over opioids.
“The contextual evidence review found that many nonpharmacological therapies, including physical therapy, weight loss for knee osteoarthritis, psychological therapies such as CBT (cognitive behavioral therapy), and certain interventional procedures can ameliorate chronic pain. There is high-quality evidence that exercise therapy (a prominent modality in physical therapy) for hip or knee osteoarthritis reduces pain and improves function immediately after treatment and that the improvements are sustained for at least 2-6 months.”
Treating Pain with Physical Therapy
All injuries and conditions are different, so your physical therapist will create a unique program for your particular condition. Some of the methods that may be used include:
- Low-impact aerobics – designed to increase heart rate before strengthening exercises.
- Strengthening exercises – using machines, resistance bands, floor exercises, like push-ups, squats and lunges, as well as other techniques to target a particular part of your body.
- Pain relief exercises – strengthen and increase flexibility in those areas where there is pain.
- Stretching – also for increasing flexibility and range of motion.
- Homework – exercises to do between sessions.
It is important to be informed and proactive in all areas related to your health but, when it comes to the use of opioids, the risks make that imperative. Before agreeing to their use for managing pain, consider getting a second opinion and exploring other options. Physical therapy is a viable and recommended alternative in treating chronic back pain.
If you have questions about back pain or any other orthopedic concern, the physicians and staff of Orthopaedic & Sports Associates of Long Island are very experienced in a wide range of orthopedic conditions and are committed to providing personalized care in a state-of-the-art facility. To schedule an appointment, or if you just have questions, please call (516) 364-0070. Our convenient online contact form is also available by clicking here.
