October is one of our favorite months for scary costumes, scary movies, and scary decorations. It is not supposed to be a month for something scary like pain. Many adults turn to opioid use to manage pain symptoms resulting from a variety of conditions, such as arthritis or low back pain, and some of these people eventually misuse these pharmaceuticals in an attempt to alleviate their pain. Each year 116 million Americans experience chronic pain. As our nation faces a health crisis resulting from an increased use of prescription opioids, the American Physical Therapy Association is making October National Physical Therapy Month, an opportunity to bring attention to this problem and offer safer solutions to pain management.
The Centers for Disease Control and Prevention (CDC) urges both prescribers of opioids and users of opioids to reduce their reliance on these prescriptions and try safer alternatives for addressing chronic pain. Several types of chronic pain respond “as well or better” to physical therapy as to prescription pain medications. Through movement and exercise, physical therapists treat pain by improving muscle strength, flexibility, and range of motion, while educating their patients on pain science and increasing their control over painful symptoms (moveforwardpt.com). A physical therapist will conduct an in-depth interview, perform an examination of movement and activity limitations, and develop a treatment plan that can relieve pain and increase participation in desired activities that were previously restricted by pain. A physical therapist (PT) may use different types of treatments and technologies to control and reduce pain, in addition to prescribing exercise designed specifically for each patient. A PT will monitor reductions in pain and adjust an exercise program in a safe and effective manner so that the patient can return to activity. Becoming more physically active is crucial for avoiding illness, falls, injury, dementia, and conditions like diabetes, hypertension, and osteoporosis. And this is a short list of how increased activity and exercise can benefit persons in pain. A PT can help break the pain cycle that continues to perpetuate the use of prescription pain medications: pain = less activity & less activity results in more pain, & more pain = even less activity, and so on and so on. A PT can help break this cycle.
The National Institute on Drug Abuse provided the following explanation for the opioid epidemic. “In 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid. That same year, an estimated 2 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 591,000 suffered from a heroin use disorder (not mutually exclusive). Here is what we know about the opioid crisis:
- Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
- Between 8 and 12 percent develop an opioid use disorder.
- An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
- About 80 percent of people who use heroin first misused prescription opioids.”
The most common opioids are codeine, Fentanyl, Hydrocodone or dihydrocodeinone (Vicodin®, Lortab®, Lorcet®, and others), Hydromorphone (Dilaudid®), Meperidine (Demerol®), Methadone (Dolophine®, Methadose®), Morphine (Duramorph®, Roxanol®), Oxycodone (OxyContin®, Percodan®, Percocet®, and others), and Oxymorphone (Opana®). Hydrocodone and oxycodone are probably the most familiar names of pain medications. If you have had a recent surgery or pain-causing procedure, then you may have noticed that physicians are limiting opioid prescriptions and asking patients to use other pain relief such as ice, heat, or over the counter pain meds. This is a positive step in limiting unhealthy reliance on opioids.
Persons who are struggling with chronic pain are urged to try alternatives to opioids, and October would be a great month to try physical therapy, one of the evidence-based, effective alternatives to prescription medications. To find a physical therapist, check the American Physical Therapy Association website (apta.org), ask your primary care provider, or ask a friend or family member who has benefited from physical therapy. I am proud to be a physical therapist, especially during National Physical Therapy Month. Don’t let pain “scare” you this October. See a PT!