CDC and Surgeon General Align on Chronic Pain Relief
Is the United States finally coming to grips with the fact we have an opioid abuse crisis? In March the CDC released their final guidelines for prescribing opioids for chronic pain, stating that “Patients with pain should receive treatment that provides the greatest benefits relative to risks. The contextual evidence review found that many nonpharmacologic therapies, including physical therapy, weight loss for knee osteoarthritis, psychological therapies such as CBT, and certain interventional procedures can ameliorate chronic pain.” As the APTA post on this says, this “delivers a clear message that physical therapists (PTs) and physical therapist assistants (PTAs) have known for some time: there are better, safer ways to treat chronic pain than the use of opioids.”
Those recommendations are reinforced by Vivek Murthy, the Surgeon General of the United States. He is leading a campaign to fight the opioid crisis; he wants his mark as surgeon general to be the fight against opioid abuse, and chronic pain relief is a large part of that. Politico quotes Murthy’s words “The drug problem is complicated, as is the solution. Physicians need to be retrained to think twice — or three or four times — before writing that first opioid prescription…The medical community has to reexamine — and more thoroughly research — its entire approach to relieving pain, both chronic and acute.”
The United States is behind many other countries in making physical therapy an early, if not first stop, for chronic pain relief. The perspective of much of the healthcare system toward hip osteoarthritis underscores this issue; although the symptoms of hip osteoarthritis can be effectively treated with physical therapy, only a small percentage of patients receive it. Why? Many healthcare providers see hip osteoarthritis as incurable – which it is – and> therefore untreatable – which ignores the fact that manual therapy and therapeutic exercise can relieve the symptoms. Painkillers and NSAIDs are their “go-to” solution until the disease is severe enough that surgery and a hip replacement is warranted.
The campaign started by the Surgeon General is hopeful, but physical therapists need to speak up with outreach to primary care providers and surgeons, and campaigns like GetPT1st to educate the rest of the healthcare system as well as the patient population. Both the healthcare system and patients stand to benefit: physical therapy in place of opioids returns both better patient outcomes and lower costs.
You can read more on the Surgeon General’s campaign in this Politico article, the details on the APTA commentary on CDC guidelines, and the full text of the CDC guidelines here: CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.