With the overuse and risks of opioids for the treatment of chronic pain becoming a national public health crisis, the Centers for Disease Control and Prevention released guidelines that recommend nondrug approaches such as physical therapy over long-term or high-dose use of addictive prescription painkillers.
"Nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred for chronic pain," the guidelines state ("CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016" - March 15, 2016). "Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient. If opioids are used, they should be combined with nonpharmacologic therapy and nonopioid pharmacologic therapy, as appropriate."
While there are certain conditions — including cancer treatment, palliative care, and end-of-life care — where prescribed opioids for chronic pain may be appropriate, the CDC cited many cases where opioid use could be greatly reduced or avoided altogether.
"The contextual evidence review found that many nonpharmacologic therapies, including physical therapy, weight loss for knee osteoarthritis, psychological therapies such as CBT (cognitive behavioral therapy), and certain interventional procedures can ameliorate (lessen) chronic pain," the guidelines state. "There is high-quality evidence that exercise therapy (a major part of physical therapy) for hip or knee osteoarthritis reduces pain and improves function right after treatment and that the improvements last for at least 2-6 months. Previous guidelines have strongly recommended aerobic, aquatic, and/or resistance exercises for patients with osteoarthritis of the knee or hip. Exercise therapy also can help reduce pain and improve function in low back pain and can improve global well-being and physical function in fibromyalgia."
Physical therapists partner with patients, their families, and other health care providers to manage pain, and reduce or eliminate the need for opioids. Research has shown that an education session with a physical therapist can lead to improved function, range of motion, and decreased pain.
Before you agree to prescribed opioids, ask your doctor physical therapy might be right for you.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. Learn more at our Safe Pain Management page.
Related Resources
- Health Center on Opioid Use for Pain Management
- Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management
- Using Opioids for More Than 30 Days Could Increase Depression Risk
- Widespread Pain is Creating Widespread Prescription Drug Use
- Health Center on Pain
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