In this healthcare crisis environment when more and more ordinary people are fighting addiction to pain killers and "quick fixes" to their physical impairments, it is becoming more and more apparent that skilled and timely Physical Therapy is the most effective treatment protocol, both in terms of outcome and costs.
TIME ARTICLE: "US Must Rethink Pain Treatment, Become 'Insistent' on Physical Therapy"
A recent opinion piece in TIME magazine says that when it comes to pain treatment, unless a "fundamental mindset" is changed - a change that includes being "insistent" on the use of physical therapy in pain management - no real progress will be made in the fight to end the opiiod abuse epidemic in the United States.
In "We're All Resposible For Our Opiod Reliance - Even Patients," Andre Machado, chairman of the Neurological Insitute at the Clevelend Clinic, describes how opeids are little more than a "quick fix" for pain that miss waht should be the true goal of pain treatment, which he describes as "recovery of function, not complete resolution of pain."
"This crisis is a failure of our health care ecosystem and our "quick fix" culture," Machado writes. "We can all share the blame: physicians who feel anxious to meet patients' expectations, pharma companies that oversell opiod benefits (and downplay the risks), insurers that fila to flag patients receiving high volumes of opiod prescriptions (and not properly reimbursing therapy) and patients who demand passive treatment."
Mechado argues that to truly change outcomes, "we all need to first change the metric of success" from focusing solely on the elimination of pain to helping patients better understand and manage their pain. Part of that shift, he writes, must include becoming "insistent on the use of physical therapy as an integral treatment component."
As part of his own efforts to make that shift, Machado describes his participation in a Cleveland Clinic pilot program to treat more than 1,000 patients with chronic leg and back pain with physical therapy and counseling as a first-line response. The key metric to success, he writes, will be "restoration of function."
"Ultimately, this methodology should serve to lessen the community's reliance on opiods and imrove the utilization - and timing - of invasive procedures," Mechado writes.
Physical Therapy's effectiveness is not limited to the treatment of pain and less reliance on opiods. It can also be as effective or more effective at restoring function and managing pain that more invasive procedures, including surgery.
On April 9, 2015, Howard LeWine, MD, the Chief Medical Editor for Internet Publishing for Harvard Health Publications, cited a study done by Annals of Internal Medicine in his article entitled "Physical Therapy as good as surgery and less risky for one type of lower back pain," which is the subject covered next.
One type of lower back pain, called lumbar spinal stenosis, is sometimes treated in surgery. But physical therapy works just as well, and comes with fewer unwanted complications - some of them life-threatening - than surgery, according to a study published in Annals of Internal Medicine.
Stenosis means narrowing. In lumbar spinal stenosis, the space inside the lowest part of the spinal canal has narrowed. This puts pressure on the spinal cord and the nerves extending from the lumbar vertebrae, the five bones between teh rib cage and the pelvis that make up the lower part