As recent as 2012, Alaska’s opioid overdose death rate was greater than double the rate in the United States (10.5 vs. 5.1 per 100,000 persons). Understanding how severe this epidemic has grown, Governor Bill Walker recently signed into law House Bill 159 in effort to prevent opioid addiction from spiraling out of control. The new law requires health care practitioners to have additional training regarding opioid abuse and also sets a cap on opioid prescriptions to 7 days-worth of pills.
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As a physical therapist, this is an issue that hits home for me because I treat people who are in chronic pain daily. Chronic pain patients have the potential to be quite challenging yet one of the most rewarding clientele to service. Challenging because chronic pain creates a “smudge” on the window of the nervous system causing it to have a warped or smeared response to pain. Kind of like driving tired in the rain and mistaking a yellow line for a school bus or vice versa, Scary, but our nervous system can only use the information provided to make critical choices about movement and behavior. Treatment of chronic pain can also be quite rewarding in respect to the vast opportunity and potential for reversing the chronic pain cycle. One of the greatest joys in our line of work is seeing a client reduce their pain medication and return back to activities that they had previously enjoyed. Not all clients achieve pain-free living, but in most cases they discover ways to manage the pain cycle using regular doses of exercise and activity rather than drugs.
Traditional medicine has developed an over-reliance on opioids to mask pain, but this treatment has many pitfalls and it fails to fix the problem. In most cases of chronic pain, the problem is no longer just the painful tissue (joint, muscle, nerve). These areas still need to be addressed to restore movement and tissue nutrition (blood flow), but it’s important to direct some treatment towards retraining the pain processing centers in the nervous system. This can be accomplished by introducing novel movement in a controlled pattern to begin breaking the association between pain and movement. For example, if looking over your right shoulder causes severe neck pain, perhaps a way to reduce this pain which occurs with normal movement is to try a novel trick like placing tongue on palate or lowering eyes in socket. Simple methods to slow movement and trick the nervous system into changing how it perceives movement. Perhaps you would no longer associate neck rotation with pain. This change of pain perceptions would then allow us to treat the actual restriction (i.e. disc, facet, nerve) and hopefully trigger some tissue healing. At Northern Edge Physical Therapy, our exercise programs are designed to reduce pain and allow clients to selectively activate muscles responsible for controlling pain.
As consumers of health care, everyone has a choice when it comes to choosing their plan of care for pain relief. Don’t get fooled by the sexy ad campaign from drug companies. It’s a sham and lie; pain medications are designed to be addictive and mood altering. They are not designed to heal musculoskeletal conditions. Instead ask your doctor and nurse practitioner for a healthy remedy which may truly lead to healing; exercise and manual therapy. Many doctors are willing to refer to physical therapy if the patient is actively seeking non-opioid options. According to the Centers for Disease Control and Prevention, pain and/or limited function associated with low back pain, hip or knee osteoarthritis, and fibromyalgia can effectively be treated through exercise and manual therapy. In addition, physical therapy has proven to be a more cost effective treatment for low back pain when compared with opioid therapy. For those struggling with chronic pain due to musculoskeletal conditions, I encourage you to face the pain with eyes wide open. Don’t let drugs mask the pain, address the real problem and give healing a chance.
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