No one wants to live in pain. But no one should put their health at risk in an effort to be pain free either. Since 1999, Americans have increasingly been prescribed opioids—painkillers like Vicodin, OxyContin, Opana, methodone, and Percocet. According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the US, even though there hasn’t been an overall change in the amount of pain reported.
In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, like cancer treatment, palliative care, end-of-life care, and certain acute care situations, if properly dosed. But for other pain management, the CDC recommends non-opioid approaches like 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, 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. 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 to find the root of the issue and improve 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. 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.
Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for non-opioid treatment. We offer free consultations so we can get to know your symptoms and determine the best method of treatment.
Given the substantial evidence gaps on opioids, uncertain benefits of long-term use, and potential for serious harm, patients should always educate themselves and consider all their options before starting opioid therapy.
Physical therapists play a valuable role in setting realistic expectations for recovery with or without opioids. Schedule your free consultation today so you can begin living pain free.