Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management

No one wants to live in pain. But no one should put their health at risk in an effort to be pain free. Since 1999, Americans have increasingly been prescribed opioids—painkillers like Vicodin, OxyContin, Opana, and methodone, and combination drugs like Percocet. According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though there has not been an overall change in the amount of pain that Americans report.

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March, 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed. But for other pain management, the CDC recommends non-opioid approaches including physical therapy.

When to choose physical therapy over opioids:
  • 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. Because of these risks, "experts agreed that opioids should not be considered firstline or routine therapy for chronic pain," the CDC guidelines state. Even in cases when evidence on the long-term benefits of non-opioid therapies is limited, "risks are much lower" with non-opioid treatment plans.
  • 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 while partnering with patients to improve or maintain their mobility and quality of life.
  • Pain or function problems are related to low back pain, hip or knee osteoarthritis, or fibromyalgia. The CDC cites "high-quality evidence" supporting exercise as part of a physical therapy treatment 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 non-opioid 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 non-opioid 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 risks to the patient.

As always, before you make a medication change, consult with your prescribing healthcare provider and educate yourself on all your options. Patients are also encouraged to consult with a physical therapist to discuss options for non-opioid treatment.

According to the CDC, as many as 1 in 4 people who receive prescription opioids long-term for non-cancer pain in primary care settings struggle with addiction.

 Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids.

Swim Personal Training :: Now Offered in Grand Rapids

Have you been wishing your triathlon swim times were faster? Looking to take the competition to the next level? Swim Personal Training is just the thing to get you there, and we're thrilled to offer it at the Northview Fitness Center Pool.

Ideal for triathletes who want to improve their stroke technique and race strategy, competitive swimmers trying to improve their performance or recover from an injury, any athlete wanting an intense workout in a change of scenery, or the person looking for a low impact general fitness program.

Swim Personal Training services can include:
- Detailed stroke technique analysis and revision
- Over and underwater high-def video recording and slow motion analysis
- Triathlon and competitive swimming race strategy counseling
- Deep water lap lane conditioning and stroke drills
- Shallow or deep water strength building exercises

Meet the instructor, Kelsey Wilterink

Kelsey grew up in Rockford, Michigan where she began swimming competitively and playing water polo in 7th grade. By the time she graduated six years later, she had won two state championships on the water polo team, set three swimming school records and earned over a dozen All-American honors for race times in the top 100 across the country. She was also given the Female Athlete of the Year award for Rockford High School. She continued her swimming career at Grand Valley State University on a full ride scholarship, and in three years she set three school records and placed in the top-16 at nationals 12 times. Having battled shoulder injuries throughout her aquatics career, she understands how crucial perfect technique is, as well developing the emotional and mental strength required to overcome obstacles and achieve top performance potential. Since graduating with honors and a B.S. In Clinical Exercise Science and a Spanish minor, she has worked in swim coaching, youth residential rehabilitation, lifeguarding, teaching water safety and swim lessons, physical therapy tech, and personal training. In her free time she enjoys doing triathlons, traveling, cooking, and helping her husband restore their 150 year old farmhouse. 

Program Details
Swim Personal Training sessions are available in 3 packs for $135, or 10 packs for $350. Discounts are available for groups of two. Sessions are available by appointment during fitness center hours. Please note, clients must be able to swim 25 yards and tread water for 30 seconds to participate. Call 616.365.6140 or stop by the Northerview Fitness Center to get signed up.

Red, White, and Blue Fruit Smoothie

Looking for a refreshing, but healthy, treat for the holiday weekend? This smoothie tastes great and it's packed full of fresh fruits. Enjoy!

1/2 banana, cut into pieces and freeze ahead of time
2 large strawberries, sliced
1/4 cup blueberries
1/2 cup milk
1 teaspoon vanilla extract
2 tablespoons vanilla yogurt
2 ice cubes

Place all ingredients in the blender, blend until smooth

The Perfect Smoothie Combination

Smoothies are the perfect alternative to breakfast, they make a great snack, or a light lunch. You can really alter the flavor by adding lots of fruits, and you'll consume your share of veggies in one sitting. Plus, take advantage of in-season fruits and fresh greens by pureeing them with a little bit of water, then freeze the mixture in ice cube trays. Each time you want to make a smoothie, grab a few ice cubes and you'll always have ingredients on hand. The image below shows a great combo to make the perfect smoothie.

Seated Core Exercises

If you think the only benefit of a strong core is a set of 6-pack abs, think again. A strong core can improve your posture, reduce back pain, improve athletic performance, help with balance, and allow you to breathe easier. 

If you're not used to working your core, it's a good idea to start slowly. We've put together a few exercises that don't even involve getting out of your chair.

The seated arm raise is going to strengthen your core and shoulders. Try 3 sets of 20, 3 times per week. Start by sitting tall in a chair with your arms in front, elbows straight, palms facing each other. Raise your arms overhead, then lower and repeat. Remember, don't arch your back or lean forward while doing this exercise. If you want to feel a little extra burn, use light hand weights for added intensity.

The seated march is great for strengthening your core and abs. Perform 3 sets of 20, 3 times per week. Start by sitting in a chair with your hips and knees at 90 degrees. Lift one leg up, lower back down, and repeat with the other leg. If you want a little more intensity try this instead: lift one leg, then straighten it out in front of you, bend and lower back down. Repeat with the other leg.

The side bend is a great way to strengthen your core and abs, as well as increase abdominal flexibility. Try 3 sets of 10 and perform this exercise 3 times per week. Start in a seated position, bend to the right then return to start. Repeat this on the left side and continue going back and forth.

If you want more exercises like these, our personal trainers are here to help. Contact the location nearest you for more information.

It's a Family Affair at Northern

Ron's Story
After years of pain in my left knee, it finally gave out in 2008 and I had a total knee replacement. That post surgical rehab was my first experience with Northern Physical Therapy and so began a relationship that would grow over the next 8 years. I later returned with a total right knee replacement, left and right shoulder rotator cuff surgeries which required therapy, and help with severe low back pain. 

When injuries happen you look for a good surgeon to be on your team of experts - someone who can help you get back on the road of recovery. The surgeon is just as important as who you choose to help with your recovery. Northern Physical Therapy is a GREAT choice to add to your support group. I've come to trust Northern and rely on their knowledge and expertise when I need help to get well from an injury, get back in shape, and return to work at my physically demanding job.

Northern Physical Therapy has also gone above and beyond in assisting me with referrals to another doctor, they've helped with billing through insurance companies, and even assisted in working through the governmental bureaucracy of Federal Workmen’s Comp issues.

Ronald and Nancy Zeerip are pictured with Nancy's therapist, Terri

Nancy's Story
My wife Nancy was having ongoing problems with bowel obstructions which ultimately resulted in a perforated bowel with peritonitis that required surgery. In one of my visits to Northern, my therapist Lisa, asked how everything was going and I relayed my wife’s issues to her and asked if physical therapy could help with abdominal surgery. Lisa suggested we see her colleague Terri, who specialized in women's issues. That advice would change Nancy’s life.

Recovery from surgery and learning to live with a colostomy was not easy. Eventually Nancy got well and a reversal of the colostomy was advised, leading to another abdominal surgery with major incisions.  The surgery and recovery process didn't go well. The incisions were painful and hard on her mentally.

At Nancy’s follow-up visit for staple removal we asked if she could get physical therapy. We hardly got the words out and we were told, “NO, there is no physical therapy needed for abdominal surgery.” Our efforts for additional discussion were met with negativity. Nancy discussed physical therapy with her Diabetic Physician and Primary Care Physician after problems arose with her left foot and leg. The diagnosis was ‘foot drop syndrome’ from nerve damage during surgery. And again after requesting therapy the reply always was that physical therapy would be of no benefit and that insurance wouldn't cover it. Nancy and I discussed it at home and even if insurance wouldn't cover it, I wanted her to try it. We thought it would be helpful and we would find a way to pay for it ourselves.

Terri works with Nancy on her physical therapy treatment

At the end of the day we asked Northern to write a request for treatment and submit it to our Primary Care Physician. The request was approved and the road back to health and physical well being began. Words like – helpful – dedicated – highly skilled – caring – just don’t seem sufficient to describe all the people at Northern and the services they've provided to Nancy and I over the years.

Northern Physical Therapy has truly changed our lives - you're a class act and we can't thank you enough for all you've done for our family.
Ronald & Nancy Zeerip, Coopersville patients

Alternative Ways to Exercise on a Treadmill

Who said a treadmill was just for running? We've got some great ways to work your calves and legs, and build strength. Next time you're just not feeling up for a run, give these a try.

Tone Your Thighs with Side Shuffles
In addition to working your inner and outer thighs, side shuffles tone your calves and make for a great cardio exercise. Stand sideways on the treadmill with your knees slightly bent. Set the speed somewhere between 3 and 5 miles per hour. You can use a Theraband strap for a little extra resistance. Quickly shuffle, landing on the balls of your feet. Do this for 5 minutes and switch sides.

Work Your Glutes with Lunges
Walking lunges on a treadmill is an ideal way to tone your behind. Set the treadmill at a very low speed and on a slight incline, about 1-2 miles per hour with a 10% incline. Practice a few times while holding on. Once you get the hang of it do 1-3 minutes of lunges followed by 2 minutes of walking. Repeat this sequence for 20-30 minutes.

Tone Your Back Side with Reverse Mountain Climbers
This variation of the traditional mountain climber emphasizes kicking your legs back, as opposed to bringing your knees in. Set the treadmill at a very slow speed, around 1 or 2 mph. Get into a plank position and begin by placing your feet on the sides of the treadmill, putting your hands on the floor. Then, put your feet on the treadmill and bring one knee into your chest while extending the other leg back. Switch legs and repeat in 30 second intervals.

Build Leg and Core Strength with Jump Squats
Set the treadmill to roughly half the speed of your average walking pace. Start by bringing your feet together at the front of the treadmill and lower into a squat position. As you reach the back of the treadmill, take a long lunge/jump forward, returning to the front of the treadmill in your starting squat position. Repeat in 30 second intervals.

East Indian Head Massage Now Offered in West Michigan

After attending an extensive training program in Arizona, our massage therapist Carrie, is pleased to be able to offer East Indian Head Massage in the West Michigan area. This highly specialized massage therapy is not frequently offered in our area, which is why we're so pleased that Carrie can now bring this service to our community.

Benefits of East Indian Head Massage
- Helps prevent migraines, headaches, and back pain
- Relieves sleeplessness, insomnia, and restlessness
- Strengthens and promotes hair growth
- Relieves symptoms of anxiety and depression
- Eliminates toxins
- Renews energy levels
- Boosts memory

East Indian Head Massage History
East Indian Head Massage, or Ayurvedic massage, is a traditional Hindi massage used for relaxation and revitalization and is one of the oldest modalities known to man, dating back 4000 years. It was traditionally done by mothers and grandmothers on their children and infants but the practice stopped on men when they reached adulthood (about age 12) due to cultural restraints. Men continued to receive head massages after that age by their barbers. The massage was originally called Champi and is where the word “shampoo” comes from.

The massage works by activating a specific series of marma or energy points by kneading, pressing, rubbing, friction, and compression to the head, neck, and shoulders. This helps rebalance energy, relax tense areas, and clear negativity. You literally can’t “think” when a practitioner is rubbing your head in this way and it feels amazing! It also helps unwind the fascia reducing wrinkles and tone the skin. If you have scar tissue on the face, it also helps relax these areas.

What to Expect
A very small amount of oil known as Bhringraj Oil is traditionally used to encourage healthy hair growth and encourage better sleep but it can be done without oil as well. Your head will smell like a sesame seed salad, and you may look as if you’ve gone through a wind storm, but your head, neck, and shoulders feel totally relaxed. The small amount of oil does not leave you greasy, but you probably don’t want to get family pictures done immediately after treatment.

Schedule an Appointment
Carrie Hine is one of the only people practicing this technique in the West Michigan area. You can schedule an appointment with her in our Wayland office. It lasts approximately 30 minutes and costs $45. The treatment is done with clients fully clothed and comfortably seated. It is not suitable for all clients so please call 269.792.4440 for a phone consultation prior to scheduling. 

Ease Back and Neck Pain with the McKenzie Method

Quick pain relief with very little intervention...sound too good to be true? People suffering from back and neck pain can often benefit from the McKenzie Method® of treatment where the patient practices certain exercises designed to eliminate pain.

The McKenzie Method® is based on the idea that self-treatment empowers the patient and reduces their dependency on medical intervention. By promoting the body’s potential to heal itself, The McKenzie Method® assesses, diagnoses, and treats patients without medication, surgery or other passive methods such as heat, ice or ultrasound. Patients learn the principles, empowering them to be in control of their own pain management, which can reduce dependency on medical intervention.

Benefits of McKenzie Method® Therapy
- Patients who are educated in self-management can practice exercise and treatment methods at the first sign of pain. Symptoms can usually be relieved before they become severe.
- When it comes to pain management, the McKenzie Method® works quickly, meaning less therapy visits overall.
- The McKenzie Method® is effective for neck, back or extremity pain, as well as shoulder, knee, hip and ankle pain.

Each of our McKenzie Method® certified therapists is highlighting a common exercise designed to reduce or eliminate back and neck pain.

The end goal of the McKenzie Method® is to teach patients who are suffering from neck or back pain how to treat themselves and manage their own pain for life by utilizing certain exercises. We ultimately want you to quickly reduce your pain and get you back to doing the things you love to do, all while minimizing the risk for the pain to return.

We offer the McKenzie Method® of Mechanical Diagnosis and Therapy® at each of our 6 locations. To see if this method is right for you, give us a call at 616.997.6172.

Summer Activities for Kids on WZZM's My West Michigan

Summer break is right around the corner and the last thing you want is the hear the kids say is, “I’m bored!” This morning we got the chance to stop by the studios of WZZM's My West Michigan to talk with Catherine Behrendt about beating the summer blahs and keeping kids active and injury-free all summer long!

Diana Painter and Gina Otterbein talk with Catherine Behrendt of WZZM Grand Rapids

We were excited to be able to share our summer kids programs, including Boot Camp, Handwriting Clinic, Swim Lessons, and RunCamp. We're offering great discounts for RunCamp right now - sign up by July 1 you can save $20 with the early bird discount code RUN. Plus, groups of 5 or more can sign up for just $75 per student! Get details on all the current kids programs here.

Check out the entire segment below, and if you have any questions on kids injuries or summer programs, feel free to give us a call.

Check out our previous segments on My West Michigan where we talked about pelvic healthweight lossusing an exercise ball, the 3 minute exercise routine, concussions in student athletes and senior health