Doctors Now Recommend Physical Therapy as an Option Over Opioids

I’d like to share a story about a patient named Gail.

Gail had severe low back pain lasting a week that began after doing an intense core exercise class. She was evaluated and received manual therapy and extensive body mechanic instruction, as to prevent further injury to her back. This instruction included how to get in and out of a chair, bed, or toilet, as well as how to walk and take care of her dog properly. By the second visit, Gail’s pain had reduced and she received more manual therapy, reviewed body mechanics, and began some core stabilization exercises. Within three to four visits, Gail’s back pain was completely gone! She was taught additional core stabilization and other maintenance exercises to keep her pain-free.

Low back pain (LBP) is the number one reason that people seek medical care.  The American Medical Association has now put out guidelines for non-invasive treatments for low back pain including non-pharmacological options such as exercise, heat, yoga, massage, acupuncture, tai chi, as well as pharmacological options that are alternatives to heavy duty opiod painkillers. The American Physical Therapy Association (APTA) has also started a movement called ‘Choose PT‘ for back pain and offers guidelines when to choose PT for pain management.

The AMA recommendations are differentiated depending on the duration of pain.

• For pain lasting less than 4 weeks (acute phase), or pain lasting 4-12 weeks (subacute phase), non-pharmacological recommendations include heat, acupuncture, massage and spinal manipulation. If medicine is also indicated then an NSAID or muscle relaxant is recommended.
• For pain lasting greater than 3 months (chronic back pain), exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation is recommended.
• When chronic lower back pain has not responded to non-pharmacological approach, medications other than opioids are recommended first. This medication guideline is important as opioid prescriptions have quadrupled in the past few years and have significant side effects.

The APTA’s “Choose PT” campaign is used to educate the public what PT can do for pain management whether it be acute or chronic. In addition to pain-relieving manual therapy techniques and appropriate exercise, physical therapists educate their patients on how to move appropriately throughout their daily activities, as not to aggravate their situation.

In my experience, patients who come in for physical therapy soon after their low back pain begins, the greater likelihood of success in resolving their symptoms.

In addition, patients get valuable instruction how to go about life so as not to make their back pain worse. Now that Gail is pain-free and understands how to move without hurting her back, she has returned to the activities she loves to do.

If you’re suffering with low back pain, get in touch to learn how physical therapy can help you become pain free and enjoy life once again.

Sources:

1) Got Back Pain? Try Yoga Or Massage Before Reaching For The Pills

2) Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians

3) Physical Therapy vs Opiods: When to Choose Physical Therapy for Pain Management