Physical Therapy vs Opioids – Four Pines Physical Therapy
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Physical Therapy vs Opioids

Dr. V. Norene Christensen |
Opioids or PT

Chronic pain is a huge issue in our society. An estimated 116 million Americans have chronic pain each year. When meeting with new patients in the clinic, I am amazed how many people are on long-term opiods for pain management, though I must admit this is fortunately lessening but not fast enough. For years the drug companies were telling the physicians how safe and non-addictive they were for managing chronic pain, but unfortunately, that was not the truth. We are seeing a medical crisis in this country as we are the largest users of opiods in the world!

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed.

Opiods are also helpful for short term pain relief immediately after surgery, not for long term musculoskeletal/nerve pain relief – ever wonder why your physician will not refill your prescription but prescribe something different? It is because they are protecting you from the ill effects of long term Opiod use.

Simple Facts about Long Term Use of Opiods:

  • General Side Effects: Constipation, Depression, Drowsiness, Nausea
  • Hyperalgesia: You think that your pain is becoming “worse” so you need a higher dosage. This is not the case, neuro-chemically, you accommodate to the dosage and over time the opiod “makes your brain neuro-chemically perceive that your pain is worse” even though it is not physically. But your experience is real and you feel that it is a physical worsening; therefore you “need” a higher dose of medication. This is the Opiod medication tricking your brain.
  • Long term high doses can make you breathe dangerously slow during sleep.
    Long term high doses of opiods affect the respiratory center of your brain by decreasing signals in the central nervous system. Click Here for a link to the Cleveland Clinic’s page on opiods and breathing. Opiod over dose death rates have increased from 8048/year in 1999 to 47,600/year in 2017.
  • Physical Dependence and Trying to Reduce Your Medication:
    Your pain worsens as you try to decrease your opiods. Opiod-induced hyperalgesia – meaning neurochemically your pain experience worsens over time needing increased dosage of medication. The same happens when you work towards decreasing your medications. You have a sense that you can’t because your pain is worse when you try - this is occurring in your central nervous system/brain and not in your musculoskeletal system. It is very hard to accept this since your pain experience is real.

That is why it is very important to work with your physician, possibly a de-prescribing physician, psychiatry or other mental health profession and your physical therapist to work through this time.

It can be very difficult and confusing for you.

But for other pain management, the CDC recommends nonopioid approaches including Physical Therapy.

Patients should choose Physical Therapy when ...

  • The Risks of Opiod use Outweighs the rewards​​​​​
  • Patient want to do more than mask the pain
    Physical therapists treat pain through movement while partnering with patient to improve or maintain their mobility and quality of lift
  • Pain or functional 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
  • Opiods are prescribed for pain
    Even in situations when opiods are prescribed, the CDC recommends that patient should receive “the lowest effective dosage,” and opiods “should be combined” with nonopiod therapies, such as physical therapy
  • The CDC cites “high-quality evidence” supporting exercise as part of a physical therapy treatment plan for those familiar conditions
  • Pain lasts 90 days
    At this point, the pain is considered “chronic” and the risks for continued Opiod use increase. The CDC guidelines note that nonopiod therapies are “preferred” such as physical therapy

How Can Physical Therapy Help You?

Click Here to Read About One Man’s Journey

Our Physical Therapists Have Extensive Training on Chronic Pain. 

  • We will listen to your story and to your journey
  • We want to hear about your challenges
  • We will fully evaluate your movements, strength, flexibility and tolerance to mobility
  • We will educate you on the neuroscience of pain to help you understand your pain, your brain, your body, effects of opiods, effects of fear avoidance and more.

Click Here to listen to Professor Lorimer Mosely talk about the Pain Revolution

We will then carefully design a program to introduce movement, aerobic activity, mindfulness and self care to gently and carefully move you towards independence and a fuller life to enjoy!

In the Great State of Wyoming, we do not need a Physician Prescription to get you started (unless you are covered by VA, Medicare, Medicaid or Worker’s Compensation). Though we would love to work closely with your physician to provide you the best care during these hard times. If you are not sure if Physical Therapy is right for you – we offer a 30 minute free consultation – no commitment necessary.

Apply for a Free 30 Minute ConsultationClick Here »
Dr. V. Norene Christensen

Dr. V. Norene Christensen

Born and raised in New Jersey, Norene came west for skiing and outdoor activities like climbing, mountaineering and mountain biking. Since being out west she also began to enjoy fly fishing, hunting, sea kayaking and snowmobiling. She enjoys fine wine, gardening and her family.
Dr. V. Norene Christensen

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