How to Manage Chronic Pain #ChoosePT

a man touching his back, with red highlight. Back pain, backache and waist pain, on white background with copy spaceIt’s no secret that we are in the midst of an Opioid epidemic in the United States of America. Prescription opioids are appropriate in certain situations such as cancer treatment, palliative care, end of life care, and acute care situations with short doses and short-term effects. However, there is low evidence of long-term benefits of opioid use to manage chronic pain. According to the Centers for Disease Control (CDC), sales of prescription opioids have quadrupled in the United States despite no overall change in the amount of pain that Americans report. The Opioid crisis has led to national campaigns for public awareness of the risks of opioid dependence and non-pharmacological therapies for pain management. There have been numerous systematic reviews demonstrating lack of substantial evidence supporting opioid use for chronic pain and no long-term benefits with long term use. In fact, the risks of opioid use outweigh the rewards. Potential side effects of opioids include depression, overdose, addiction, and withdrawal symptoms when stopping opioid use. There are various evidence-based interventions that can be implemented to manage pain with evidence of long term benefits. There is high quality evidence that physical therapy is a long-term nonpharmacological therapy that can manage chronic pain through the promotion of movement to improve mobility and QOL.

The evidence of long term benefits of physical therapy on pain management has been researched for many years resulting in Clinical Practice Guidelines which are evidence-based treatments that can help manage pain and promote movement and activity participation for improved quality of life. The CDC states, “the contextual evidence review found that many nonpharmacological therapies, including physical therapy, weight loss for knee osteoarthritis, psychological therapies such as cognitive behavioral therapy, and certain interventional procedures can ameliorate chronic pain.” There is high quality evidence that exercise therapy, a prominent intervention in physical therapy, improves function with long term effects. Physical therapists partner with patients, families, and other healthcare professionals to work as a team to manage pain without the need of opioids. Physical therapy uses multidisciplinary approaches to manage pain such as incorporating relaxation techniques and diaphragmatic breathing for self regulation of stress and tension, education on coping strategies, pain management techniques through modalities and movement, and exercise prescription with evidence-based approaches using the Clinical Practice Guidelines and individualizing a plan to each patient. If you are experiencing pain, consider physical therapy over the risky alternatives.

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