Physical therapy, a safe alternative to opioids in pain management

In response to the growing opioid epidemic, APTA has launched a public education campaign, #choosept, to raise awareness among patients and prescribers about physical therapy, as a safe alternative to opioid drugs for pain management.

While opioids prescription are appropriate and effective for moderate to severe short-term pain such as pain associated with acute injury, cancer treatment, palliative care, and end-of-life care, there is little or no emphasis on the risk it poses to patients which include constipation, depression, addiction, overdose, and withdrawal symptoms when a patient stops the use of opioid medication. Also, opioids such as codeine, oxycodone, methadone, hydrocodone, and others may reduce the sensation of pain, by interrupting pain signals to the brain, but they do not treat the conditions that cause the pain.

Centers for Disease Control recommends in a new set of guidelines that in situations when opioids are prescribed, patients should receive “the lowest effective dosage,” and opioids “should be combined” with nonopioid therapies, such as physical therapy. Every physical therapist has a role to play in educating their patients about the well known, documented, side effects and dangers of the long-term use of opioids and why they should consider physical therapy as a first point of action for pain control.

Physical therapy is a conservative treatment method addressing healing, prevention of injuries and disabilities. The focus is primarily, but not solely, on relieving pain, promoting healing, restoring function and movement, and facilitation and adaptation associated with injury. It also focuses on ergonomics or body mechanic training, fitness and wellness and, patient education.

The use of physical therapy has been known to play a vital role in not only relieving pain, but its source which involves active participation from the patient. Physical therapists focus on education (posture, pacing,disease, remaining active), exercise (aerobic, strengthening, stretching, motor control), manual therapy (massage, joint mobilization and manipulation), electrical stimulation (TENS, interferential current) heat modalities (hot packs, ultrasound), cold modalities (ice pack, ice bath), motor imagery, sensory re-education and virtual reality in pain management. In addition, physical therapy interventions have proven to be effective in common musculoskeletal conditions such as back pain and  chronic pain  which ultimately reduces job-related disabilities, absence from work and cost of care.


Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment.


Related Resources:

 Using opioids for more than 30 days could increase depression risk

 Physical therapy vs opioids: when to chose physical therapy for pain management

 Physical therapy a safe alternative to opioids for fibromyalgia pain

Role of Physical Therapists in pain management explored

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