Home Career Op-Ed: Does physical therapy work for severe pain?

Op-Ed: Does physical therapy work for severe pain?


Chronic pain affects 1 in 6 people in the United States and worldwide, and appears the most common cause of disability. However, medicine’s desperate attempts to treat chronic pain have created an opioid epidemic. And while there are many promising non-opioid treatments, some of which are newly developed, patients face countless barriers to accessing them.

To overcome the opioid epidemic, it is not enough to simply reduce the number of opioids doctors prescribe. We need to be able to offer patients evidence-based alternatives. But for that to happen, we also need to understand better the fundamental nature of chronic pain, which so many emotions that we feel in our mind as it is a physical sensation that our body experiences.

Acceptance and Commitment Therapy and physical exercises safer and more effective for chronic pain than opioids that actually can increase pain in those with chronic pain.

“As a hospice nurse, I feel like I understand pain management pretty well,” said Jeanne Dietrich-Harrison, whose son died of an opioid overdose last year after being prescribed medication for chronic pain caused by pancreatitis. “Even with dying patients, we use a multi-pronged approach, not just opioids.”

Unfortunately, services such as physical and cognitive therapy have been hit hard by the COVID-19 pandemic with the closure of many pain management facilities. And considering that there is only 74 certified pain rehabilitation centers throughout the United States, the need and demand far exceeds the supply of these powerful drugs even in the best of times.

Advances in addressing the emotional and psychological aspects of pain offer a ray of hope for those in chronic pain. Online interdisciplinary programs have been shown to effective for chronic pain. Other innovation incorporate telemedicine for harm reduction services for patients prescribed opioids; expanding group therapy sessions and pain relief; and greater flexibility in home delivery of prescriptions.

A new form of cognitive therapy called pain relief therapy – which the researchers say teaches people that “the brain actively creates primary chronic pain in the absence of tissue damage and that re-evaluating the cause and threat value of pain can reduce or eliminate it” – resulted in 52% of back pain patients suffering from pain. free, compared to only 16% of those who received regular care.

The search for alternative treatments for chronic pain has begun to push the very boundaries of what constitutes treatment. In November 2021, the Food and Drug Administration the first virtual reality system is approved shown in randomized clinical trials to help people with chronic low back pain. The system includes methods such as distraction, relaxation, behavior modification and increased body awareness, in daily virtual reality sessions over an 8-week course.

As we face the growing opioid crisis, it is critical not to repeat the mistakes of the past. The main reason chronic pain patients suffer is because they have been treated by a system that favors quick prescriptions or lucrative procedures. no of which actually relieve chronic pain. The White House presented it National drug control strategy last April, which, while fairly comprehensive, does little to ensure that patients with chronic pain have greater access to multidisciplinary pain management.

Both the federal government and individual states should push public and private insurance programs to provide easier access to multidisciplinary and alternative pain management, and perhaps even consider mandating coverage for certain services.

At the same time, it is important to review practices that offer limited benefits. For example, according to doctor Steven Atlas, spinal fusion surgery to have “become the poster child for expensive, risky, and unnecessary back surgery,” and the Medicare advisory committee gave extremely cool evaluation of evidence to support procedures. Yet Medicare and other insurance companies continue waste billions of dollars a year on them.

Many people living with pain have found that working from home is a benefit and employers should continue to offer this flexibility to people with disabilities and their carers.

Funding for research into innovative approaches to treating chronic pain needs to be increased, but at the same time, the FDA must maintain a high level of oversight to ensure that only the safest and most effective treatments are promoted.

The US Centers for Disease Control and Prevention recently updated its guiding principles in chronic pain. The agency has lifted some restrictions on opioid prescriptions and is recommending non-opioid therapies as primary care for chronic pain, but the guidelines could have provided clinicians with additional guidance on how best to incorporate these options into the management of patients with chronic pain.

People with chronic pain must show great resilience. They need health professionals who can offer innovative, holistic approaches – beyond drugs – that have been shown to bring relief.

Haider Warreich is a physician at Brigham and Women’s Hospital, Harvard Medical School, and the Boston Veterans Affairs Health Care System, and the author of “The Song of Our Scars: The Untold Story of Pain.”

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