physical therapy helping man walk down hall

Practical Ways Physical Therapists are Tackling Opioid Abuse

There’s nothing much worse than living with chronic pain, whether the cause is injury, disease or nerve damage. People who are hurting every day are often desperate to get relief, which can lead down a dangerous road. Instead of turning to addictive prescription opioids, the Centers for Disease Control and Prevention (CDC) recommends a physical therapy routine as a safer alternative.

What are opioids and what is the problem?

According to the American Society of Addiction Medicine, opioids are a class of drugs that include the prescription pain relievers oxycodone, hydrocodone, codeine, morphine and fentanyl, as well as the illicit drug heroin. More than 52,000 Americans died of a drug overdose in 2015, making it the leading cause of accidental death in the United States. Opioids are responsible for more than 60 percent of these deaths, as 20,101 deaths were due to prescription pain relievers and 12,990 were related to heroin.

The Centers for Disease Control and Prevention reports that the rates of prescription opioid sales and related overdose deaths have quadrupled since 1999, with 183,000 Americans dying from prescription opioid overdoses between 1999 and 2015. While not all prescription opioid users abuse their medication, as many as 25 percent of long-term, non-cancer pain patients struggle with addiction. Additionally, more than 1,000 people are treated every day in hospital emergency rooms for misusing prescription opioids.

On a more local level, four of the top 20 cities in the U.S. for opioid abuse happen to be in Texas, with Texarkana coming in at number 10, followed by Amarillo at 13, Odessa at 15 and Longview at 17.

Why is physical therapy a smart alternative choice for pain?

While the APTA acknowledges that prescription opioids have a place in treating chronic pain, they also raise a patient’s risk of depression, addiction, withdrawal symptoms and overdose, as well as the probability of becoming addicted to heroin, at a rate of more than 40 times the average person. In fact, research published in JAMA Psychiatry reports that 94 percent of heroin users choose it over prescription opioids because it is cheaper and easier to obtain.

The APTA hopes to offer non-pharmacologic relief to pain sufferers through a combination of physical therapist–supervised movement and exercise, which can boost a person’s strength, flexibility and range of motion. Patients also have been shown to benefit from pain education with their physical therapists.

Physical therapists seek to help patients achieve pain-free movement by identifying, diagnosing and treating issues, which can improve the quality of life of patients at work and during play. Therapy also allows patients to avoid opioids if possible, and actively engage in their own recovery by putting in the time and effort to strengthen their bodies. Patients may also be able to avoid costly and invasive surgery, especially in cases of meniscal tears, osteoarthritis in the knee, rotator cuff tears, spinal stenosis and degenerative disk disease, in which physical therapy has proven especially effective.

How do physicians and physical therapists team up to help patients treat their pain?

Tim Kotera, physical therapist and director of physical medicine and rehabilitation at Texas Health Harris Methodist Hospital, says a patient’s health care team will work together to determine the best course of action for pain management.

“Physical therapists always work with physicians to promote physical activity over the use of medication,” he explains. “Physical therapy is a great tool that physicians can use to help with pain management. I think physicians are always open to alternative modalities as long as they are helping achieve positive results for their patients. I feel that everyone in the health care industry knows what a problem opioids are so everyone is willing to do their part.”

Kotera has seen physical therapy work time and again, which should make any patient struggling with pain willing to give it a shot.

“Our patients that have pain usually complete our program with less pain and discomfort than they came in with. There are several studies that show physical activity helps with treatment of pain by releasing endorphins, which is our own body’s defense against pain. This not only helps with pain control but the patients also actually feel better by increasing their activity.”

To find a skilled medical provider or physical therapist to manage your chronic pain concerns, call 1-877-THR-WELL (1-877-847-9355) or visit

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