Avoid the Painkiller Trap.
Choose PT First for Pain.

Pain is only a symptom. If you want to end your pain, treat the causes.

By Dan Hellman

The Florida Physical Therapy Association (FPTA) recently launched a campaign called PT for Pain. Its target is the false hope of painkillers. And its goal is to get people to use physical therapy to treat their pain rather than masking it with painkillers, particularly opioids.

This campaign goes hand in hand with the campaign the American Physical Therapy Association (APTA) has launched called Choose PT, through which they are encouraging people to make physical therapy a first step—before drugs or surgery. I discussed how physical therapy can be used to avoid surgery in my blog post of April 9, 2019. 

As a physical therapist, I applaud and support this campaign from two points of view. First, I want my profession to get the recognition it deserves for the outstanding work we do, and I want more people to know the value of physical therapy and seek it out. Physical therapy can help people avoid surgery, gain greater mobility and avoid injuries. It can be especially valuable for senior citizens, who need to keep these attributes strong in order to avoid dangerous falls.

Drugs don’t eliminate pain, they mask it.

As a citizen and human being, however, I am also deeply concerned that people are turning to powerful addictive drugs–particularly opioids–that don’t eliminate the source of their pain.

That is where dependency and addiction start. The only time some people are free of their back pain, shoulder pain, hip pain or neck pain is when they are on medication. When the medication wears off, the pain returns.

We Americans like fast and simple solutions, and drugs can be tempting.  On the other hand, physical therapy takes some work and commitment. You have to make the time and the effort to see your therapist and follow the exercises and other instructions he or she gives you. A pill seems much easier, but we have seen how destructive reliance on painkillers can be.

Pain is your body talking to you.

Pain has a useful purpose. It’s the language your body uses to tell you something is wrong. When the pain begins to subside, your body is telling you it’s getting better. Unfortunately, you have to endure some pain in the short term, which you can alleviate with relatively safe drugs like ibuprofen (which is also an anti-inflammatory) while you are doing corrective work. If you need stronger relief, proceed very carefully, mindful of the need to step down your use of painkillers and stop using them as soon as possible. The rewards come quickly and grow steadily as you have less and less pain, thanks to the program your physical therapist has designed for you—and that you are diligently following.

Painkillers can make pain worse.

Not only do painkillers not treat pain, they actually can help make it worse. When we feel pain, we avoid the movements that cause it, which can relieve stress on the injured area and allow it to rest somewhat. But if we don’t feel the pain, we may move as we normally would, actually increasing the stress on the injured area. That is one reason why so many people who are on painkillers say that their pain seems to get worse after the effects of the painkillers wear off.

Think of it like this: If a fire alarm went off in your house, would you get angry and try to turn the alarm off, or would you try to find the fire and put it out before it spread? You could turn the alarm off, and that would relieve you of the annoying squeal of the alarm, but your house—well, there’s that, of course. That pain you feel is like a fire alarm. It is warning you, so don’t silence it. Learn what it is trying to tell you.

Physical therapists are medical professionals.

Physical therapists are medical professionals. They are experts in human movement and rehabilitation, often with highly technical advanced degrees. They diagnose problems and develop individualized and fully integrated courses of treatment. I know many doctors who gladly step aside to let a skilled physical therapist take charge of a patient. A doctor rarely intervenes in the treatment a physical therapist prescribes.

The CDC recommends physical therapy.

That is why the Centers for Disease Control and Prevention (CDC) recommends that people in pain turn to physical therapy before using dangerous pain medications. It is also why the FPTA and the APTA are campaigning hard to get health plans to provide better coverage for physical therapy. If health plans show a preference for medication over therapy by their coverage rules, more people will turn to drugs. We can turn that around, and we should.

I urge everyone to support these campaigns. Contact your state legislator or member of Congress and urge them to press for better coverage of physical therapy in health plans. Then please advise friends and family members who are dealing with pain to seek out the best physical therapists they can find before they opt for painkillers or expensive and intrusive surgery. There are many wonderful physical therapists out there, and they are doing great work.

And by the way, if you are looking for a physical therapist near Fort Lauderdale, get in touch. I would love to help you.

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