Opioids are commonly prescribed for pain. An estimated 20% of patients presenting to physician offices with noncancer pain symptoms or pain-related diagnoses (including acute and chronic pain) receive an opioid prescription.
In 2017, health care providers across the US wrote more than 191 million prescriptions for opioid pain medication—a rate of 58.7 prescriptions per 100 people.
The CDC recommends nonopioid approaches including physical therapy.
Patients should choose physical therapy when …
... The risks of opioid use outweigh the rewards.
Potential side effects of opioids include depression, overdose, and addiction, plus withdrawal symptoms when stopping opioid use. The CDC guidelines state that because of these risks, "experts agreed that opioids should not be considered first line or routine therapy for chronic pain,"
... Patients want to do more than mask the pain.
Opioids reduce the sensation of pain by interrupting pain signals to the brain. Physical therapists treat pain through movement and other therapies.
... Pain or function problems are related to low back pain, hipor knee osteoarthritis, or fibromyalgia.
The CDC cites "high-quality evidence" supporting exercise as part of a physical therapytreatment plan for those familiar conditions.
... Opioids are prescribed for pain.
Even in situations when opioids are prescribed, the CDC recommends that patients should receive "the lowest effective dosage," and opioids "should be combined" with nonopioid therapies, such as physical therapy.
● ... Pain lasts 90 days.
At this point, the pain is considered "chronic," and the risks for continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are "preferred" for chronic pain and that "clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh the risks to the patient."
Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids.
If pills are taking over and masking your pain, call us at Dynamic Edge to see if we can help.
CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 Recommendations and Reports/ March 18, 2016 / 65(1);1–49. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm
Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management: https://www.moveforwardpt.com/resources/detail/physical-therapy-vs-opioids-when-to-choose-physica
ER Reduces Opioid Use By More Than Half With Dry Needles, Laughing Gas: NPR, February 20, 2018. https://www.npr.org/sections/health-shots/2018/02/20/577139699/er-reduces-opioid-use-by-more-than-half-with-dry-needles-laughing-gas
7 Staggering Statistics About America's Opioid Epidemic: https://www.moveforwardpt.com/resources/detail/7-staggering-statistics-about-america-s-opioid-epi