Why Physical Therapy is the Better Option for Pain Relief The Opioid Epidemic

Quote by the CDC: “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. Previous guidelines have strongly recommended aerobic, aquatic, and/or resistance exercises for patients with osteoarthritis of the knee or hip. Exercise therapy also can help reduce pain and improve function in low back pain and can improve global well-being and physical function in fibromyalgia.” [6]

Opioid Epidemic In America

The opioid epidemic in America is real.  For the first time, traffic fatalities have been surpassed by opioid related deaths. [1]. According to the American Society of Addiction Medicine, prescription opioid fatalities amounted to over 20,000 deaths in 2015, higher than heroin related deaths that amounted to only about 13,000 fatalities, [4].  In addition, opioid related deaths and injuries (classified as unintentional injury deaths by the CDC) was the leading cause of injury related death for the age bracket of 25-64 years old [5].

Reasons Why Opioids May Not Be Warranted For Short Term Pain Relief

Although the Center of Disease Control does acknowledge opioid medicine to be effective at relieving short term symptomatic pain, studies by the CDC suggest that risk of addiction may make opioid usage a problematic source for short-term pain relief. According to CDC, patients who use opioids within 7 days following surgery had a greater risk of usage after one year [2].  This data suggests that even short-term opioid usage may be linked to long-term opioid dependence.  In addition, short-term pain relief from opioid medicine does not equate to beneficial long-term outcomes.  Studies done by the CDC report finding no evidence that opioids continue to have a benefit in reducing pain after one year, compared to a placebo intervention where no opioids were prescribed [2].

How Physical Therapy Can Be An Effective Alternative For Pain Relief

Unlike prescription medicine, where the intention is to only mask symptoms of pain, Physical Therapy serves as an outlet to fix pain symptoms at the source by addressing functional impairments and muscle imbalances through quality efforts. Physical therapy not only serves to mitigate the physical symptoms of pain, but it also serves to address the emotional aspects of pain by providing verbal encouragement and patient education. According to the APTA, physical therapy has been shown to increase function, range of motion, and pain symptoms even by just an education session with a therapist [6]. In addition, extensive studies by the CDC and APTA show evidence that nonpharmalogical and non-opioid pharmologic treatments present benefits without the harm associated with opioid therapy [2,3]. It offers benefits of increased functionality physical health and fitness that opioid therapy cannot offer.

What is the Take Home Message?

Prescription opioid medicine may be an attractive source for pain relief due to its simplicity of usage, however its risk for physical harm and dependence advocates Physical Therapy to be a safer and more effective option for pain relief both in the short term and long term. It achieves this goal by addressing both the physical and emotional symptoms of pain at the source of injury, rather than using drugs that only cover up the physical pain in the short term.

(1)     https://newgradphysicaltherapy.com/opioid-epidemic-physical-therapy/  (opioid vs car crash statistic)(2)    https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm  (cdc article on why opioid use for long term)(3)    https://www.moveforwardpt.com/DidYouKnow/Detail.aspx?cid=cd15e2c9-922e-4b95-bfdb-97247f894f41  (apta website)(4) https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

(5) https://www.cdc.gov/injury/wisqars/LeadingCauses.html

[6] https://www.moveforwardpt.com/DidYouKnow/Detail.aspx?cid=cd52bad5-f4a3-4f1f-a387-9cd4a3bc1842