“It hurts! I can’t stop taking pain pills!” This is the familiar cry of the multitudes of people who are causing or perhaps you might say are victims of this country’s opioid epidemic. The Centers for Disease Control says that opioids are appropriate in certain cases – think cancer treatment, end-of-life care – but for other pain management non-opioid approaches such as physical therapy are recommended.
The American Physical Therapy Association says that the long-term the risk of opioid use outweighs the rewards. “The 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 first-line or routine therapy for chronic pain.”
I recently sat down with rehabilitation director, Michelle Tucker and physical therapist Shawna Andres both of Bonner General Health’s Performance Physical Therapy to talk about this subject.
“I just worked with a patient who is a great example,” Andres said. “She called her doctor wanting to have her prescription for Oxycodone renewed and it was denied.” This 70ish woman recently had back surgery and will work with Andres twice a week for six to eight weeks to regain her strength. Andres said that fortunately the woman is very motivated.
“Attitude is half of it. This woman loves gardening and volunteers in the community,” Andres said. “So, she may not even need the full six weeks of therapy.”
What it comes down to for some people is, how easy will it be to have therapy? Obviously, taking a pill takes little effort. But it’s easier to make a case for spending a few hours in therapy as opposed to a life with a prescription drug addiction that also causes dizziness, nausea, vomiting and constipation.
Tucker explained that when a patient comes for physical therapy, the PT will do an assessment based on the diagnostics such as MRIs, x-rays, etc. And, based on that assessment they will choose various modalities that will offer the best success for the patient.
Heat, ice and massage sound more like a day at the spa than therapy. And who wouldn’t enjoy a dip in a warm pool? Where do I sign up?
“Aquatic therapy reduces joint compression and increases soft tissue mobilization,” Tucker said. “There’s also Electrical Stimulation Ultrasound which blocks pain receptors and reduces inflammation. Ultrasound increases blood flow to aid in healing. There’s so much we can do.”
Both Tucker and Andres are keen on TENS (Transcutaneous Electrical Nerve Stimulators) Units for pain management. Andres said that one of the best things about these devices is that they can be put anywhere, back, legs, shoulders, knees, or any other part of the body.
The manufacturer says that “TENS machines works by sending stimulating pulses across the surface of the skin and along the nerve strands. The stimulating pulses help prevent pain signals from reaching the brain. TENS devices also help stimulate your body to produce higher levels of its own natural painkillers, called ‘endorphins.’”
Andres said that she currently has three post-back surgery patients undergoing physical therapy. “One woman in her sixties wasn’t fit before rehab, so it’s a longer, slower recovery. The more physically fit someone is before surgery makes a big difference.”
Tucker said that physical therapy isn’t just about spending time in the rehab center. It’s about learning exercises to be done at home. It’s about learning techniques on how to get on with daily activities.
“Perhaps a patient will need adaptive equipment such as a walker, or a device to help them pick up their socks off the floor. We’ll teach them how to roll out of bed and other body mechanics,” Tucker said.
The idea that physical therapy can eliminate everyone’s need for opioids is, unfortunately, not a realistic one. Andres told me about a patient who found physical therapy too painful and we all know people whose personality leans towards addiction.
Today, if just one of my readers chooses to try physical therapy instead of popping an opioid, I’ll be happy. And, as a reminder, please drop those unneeded meds off at the police station so they don’t get into the wrong hands.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Committee. She can be reached at 264-4029 or firstname.lastname@example.org.