Five Reasons Why Physical Therapy is a Good Alternative to Opioids for Pain Management

Introduction

According to statistics published by +he Good Body, between 11% and 40% of adults in the U.S. are living with chronic pain at a cost of $635 billion every year, and 2017 saw 191 million opioid prescriptions. In addition to being costly, opioid pain medication can become highly addictive and carry a long list of potential side effects that range from mild to potentially fatal. August 31st is International Overdose Awareness Day, and we at FYZICAL Therapy & Balance Center in Corpus Christi want to share how physical therapy can help with pain management and reduce the need for opioids.

Chronic pain is defined as persistent pain that lasts longer than three months. Chronic pain can affect your ability to do your job. For example, one of our patients reported that she had to close her pet-sitting business. “It’s very hands-on,” she said, “and I just couldn’t tolerate walking the dogs, cleaning up after them, or even petting them.” Chronic pain can also affect your activities of daily living. We’ve had patients come to us for pain management, so they can return to tasks like folding towels, mowing the lawn, or buying groceries. One thing they all report is that the pain is always top-of-mind, limiting their mobility, and for many, this results in added emotional struggles as they deal with depression, anxiety, or anger.

Back pain is the most common type of pain we treat at the clinic. This is in line with national statistics. Verywellhealth.com cites research from the University of North Carolina at Chapel Hill that reports that “no less than 84% of adults in the U.S. will experience chronic back pain at some point in their lives.” We also see patients coping with pain from arthritis, sciatica, diabetic neuropathy, cancer, or carpal tunnel syndrome. Whatever the cause, physical therapy can help and is a healthy, effective alternative to opioid medication.

Here are five reasons why physical therapy is a good alternative to opioids.

Reason #1: Physical therapy is non-addictive.

One of the most damaging consequences of using opioids is their addictiveness. The statistics are startling. Here are some numbers from the National Institute on Drug Abuse:

• In 2019, nearly 50,000 people in the U.S. died from opioid related overdoses.
• The misuse of opioids costs the U.S. $78.5 billion a year.
• About 8-12% of people using opioids for chronic pain management develop an addiction.

Opioid addiction has become a major health crisis in recent years, and strategies are being enforced to overcome it. One of the strategies is finding better practices for pain management such as physical therapy, which can reduce pain either directly, through hands-on techniques, or indirectly through increased range of motion and strength. “When a patient comes to me for pain management,” states our therapist, Dr. Gene Lopez DPT, “I first work to provide some immediate relief with interventions like ice massage, electro-stimulation, manual therapy, and/or taping, but my ultimate goal is to give patients long-term relief. That’s when I take them to the gym to teach them stretches for improved range of motion and exercises for building strength.” And while physical therapy isn’t a chemically-induced addiction, we do hope that our patients become “addicted” to the healthy lifestyle that it promotes.

Reason #2: Patients have fewer side effects and health risks with physical therapy.

Many medications have harmful side effects and the same is true for opioids. Some common side effects are drowsiness, dizziness, nausea, brain fog, constipation, and slowed breathing. An article by the Mayo Clinic describes why opioids are sometime dangerous: “At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death.”

Thus, taking opioids relieves pain but at the cost of other physical ailments. Physical therapy, on the other hand, can relieve pain without those negative side effects. “The only complaint my patients sometimes have is muscle soreness,” shares Dr. Lopez, “but it’s temporary, and it’s the result of exercising muscles that haven’t been used in a long time. The benefits of strengthening those muscles far outlasts the soreness and contributes to successful pain management overall.”

Reason #3: Physical therapy is more individualized than opioid medication.

Opioid prescriptions can relieve all types of pain from acute post-surgical pain to chronic pain from arthritis or diabetic neuropathy. In this way, taking medication is a one-pill-fits-all type of solution. Physical therapy is much more individualized. Each patient’s plan of care is specific to their ailment, their history, and their lifestyle. How we treat back pain, for example, is different than how we treat pain from an autoimmune disease like lupus, and within the back pain spectrum, we tailor treatments according to the patient’s goals. So instead of masking pain, physical therapy addresses the causes, keeping in mind that everyone’s body is different.

Reason #4: Physical therapy provides healing for both the body and the mind.

As mentioned earlier, chronic pain often has emotional consequences like anxiety or depression, and treatments like opioid medications are solely focused on alleviating pain without considerations about the cause or the resulting emotions.

The emphasis of physical therapy may be on the body, but in truth, it provides a holistic approach to healing. The connection between body and mind is strong. Stress often manifests in tightened muscles, particularly in the shoulders and neck. Before any exercise program, our therapist teaches relaxation techniques. “Emotional tension leads to body tension, which leads to pain. We have to help people relax,” says Dr. Lopez DPT, who often has heart-to-heart conversations about lifestyle choices that may be contributing to the pain.

There’s an added benefit to physical therapy. PTs may not be counselors, but after working with patients for weeks or months at a time, they often become friends.

Reason #5: The effects of treatment with physical therapy last longer than with opioid treatment.

Perhaps the greatest disadvantage of pain medication is how temporary it is. Once the pill wears off, the pain returns, so the patient takes another pill and repeats the cycle.

Our physical therapist, Dr. Lopez DPT, has this to say: “A lot of pain management is recognizing the imbalances that are causing pain in the first place because the muscles, bones, and joints are trying to compensate for those imbalances. Another important part of pain management is teaching the patient about good posture and proper body mechanics for movement throughout the day.”

Thus, the exercises, habits, and other skills that individuals learn in physical therapy can and should be continued for the rest of their lives. Developing these habits will prevent an intensification of pain and may also prevent the development of new aches. Some of our patients may not be able to reach a zero level of pain, but if we can get them from an 8 out of 10 to a 3 out of 10 on the pain scale, then their quality of life can significantly improve.

Conclusion

The misuse of opioids has become a national crisis, costing billions, and affecting the wellbeing of so many people. While there are other non-addictive medications like ibuprofen or steroid shots, they do not provide long-term relief because they do not address the root causes of pain or educate the patient in pain management strategies and proper body mechanics.
Our team in Corpus Christi is dedicated to providing coaching and education to help patients prepare for a life free of addictive opioids. With a personalized therapy program, the FYZICAL team can help you gain confidence in managing chronic pain. Together, we can #endoverdose.

References

“29 Chronic Pain Statistics: Facts, Figures, and Research.” The Good Body. January 25, 2021. Retrieved from https://www.thegoodbody.com/chronic-pain-statistics/
“4 Common Types of Chronic Pain.” Verywellhealth. December 2, 2020. Retrieved from https://www.verywellhealth.com/conditions-most-often-associated-with-chronic-pain-2564563
“Opioid Overdose Crisis.” National Institute on Drug Abuse. March 11, 2021. Retrieved from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
“What are opioids and why are they dangerous?” Mayo Clinic. March 21, 2021. Retrieved from https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/expert-answers/what-are-opioids/faq-20381270