Chronic Pain and Physical Therapy

We often hear of physical therapy being used to help patients with rehabilitation, many times after a surgery or any traumatic experience. However, it’s hard for many people to think that physical therapy can actually be used to treat chronic pain as well. In fact, did you know that the Centers for Disease Control and Prevention (CDC) actually recommends physical therapy and other non-drug options for chronic pain? For those of us that aren’t fully aware, chronic pain is defined as pain lasting more than 12 weeks and affects over 116 million Americans yearly. Even though the condition is often lumped into one category, it is important to keep in mind that chronic pain often varies greatly and can be treated in many different ways. As such, it’s common for patients to be put in multidisciplinary treatment programs. While seeking for medical advice on treatment is important, there are also some key things to keep in mind.

Recently, there’s been a growing national issue with the use of opioids that has subsequently carried over into their use in the treatment of chronic pain. There are many risks to opioid use and the rise in overdose deaths has become a national concern. In many cases, doctors have been seen to use opioids as a go-to treatment that may result in drug abuse or reliance in the medicine, not focusing on treating it long-term at all. In reality, opioids should be used only in the case of a strong need to function, such as cancer treatment or palliative care. Because of this, the CDC recommends non-drug options for treatment of chronic pain as they are believed to be cases where the benefits don’t outweigh the risks. According to the CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016, there is a large amount of evidence that points towards physical therapy being an effective treatment for chronic pain in both pain and function management.

In using physical therapy to treat chronic pain, you should expect multiple sessions and possibly practicing exercises at home for maximum effect. The sessions might include a mixture of low-impact aerobic training exercises that increase heart rate but go easy on the joints, strengthening exercises that might focus on core muscles or other parts of the body, pain-relief exercises that target pain areas, or stretching. These exercises are targeted to relieve pain and manage body function, but rarely hurt the patient. Physical therapy treatment of chronic pain is believed to be more thorough because not only can therapists treat patients with flexibility exercises, posture awareness, and body mechanic instructions, but they can also help them understand the primary cause of their pain. Additionally, having someone to instruct them on what helps their pain and what doesn’t, how to work with their pain, and repeating words of encouragement throughout is a understandably longer-lasting treatment than opioids.

Physical therapy has been found effective in reducing pain and improving function for at least 2-6 months. According to the CDC Guidelines, physical therapy should be chosen for pain management over a variety of situations. This includes, but isn’t limited to cases such as when the risk of opioid use outweighs the rewards, when patients want to do more than simply reduce pain, when the pain or function problems are related to areas such as the lower back, hip, knee, or fibromyalgia, and when pain lasts 90 days. If you’re struggling with chronic pain, any of these situations could be you, so next time you’re talking to your doctor about treatment for your chronic pain, remember that physical therapy may be a better and safer option than opioids.

References:

.https://www.moveforwardpt.com/DidYouKnow/Detail.aspx?cid=cd52bad5-f4a3-4f1f-a387-9cd4a3bc1842

https://medlineplus.gov/magazine/issues/spring11/articles/spring11pg5-6.html

http://www.apta.org/PTinMotion/News/2015/1/14/ChronicPainNIH/

http://www.apta.org/Media/Releases/Consumer/2013/12/5/

https://www.webmd.com/a-to-z-guides/condition-15/pain/physical-therapy

Naile Ruiz