Tag: pain management

Failed arthritis drug may prevent opioid addiction

A drug already proven safe for use in people may prevent opioid tolerance and physical dependence when used in combination with opioid-based pain medications, according to a new study in mice.

Researchers have discovered that a compound previously tested to treat osteoarthritis pain appears to block neuropathic pain and decrease signs of opioid dependence.

When drug manufacturer Eli Lilly and Co. conducted human trials of the drug to treat osteoarthritis pain, they found that the drug lacked efficacy. Researchers had not, however, tested the drug’s use in treating other kinds of pain and lessening opioid dependence.

Full story at Futurity

PTJ Special Issue Podcasts: Physical Therapy for Pain May Reduce Overall Costs, Opioid Use

For some patients, physical therapy can both decrease overall health care utilization and save money down the road—especially if delivered sooner rather than later. These were the takeaways from 2 articles in a May 2018 special issue on nonpharmacological management of pain published by PTJ (Physical Therapy), APTA’s scientific journal. PTJ Editor-in-Chief Alan Jette, PT, PhD, FAPTA, interviewed authors of each of the studies via podcast.

One study, coauthored by Xinliang “Albert” Liu, PhD, examined the effect of timing of physical therapy on downstream health care use and costs for patients with acute low back pain (LBP) in New York state. The patients were categorized by whether and how soon they received physical therapy after seeing a physician for LBP: at 3 days, 4–14 days, 15–28 days, 29–90 days, and no physical therapy. Patients who received physical therapy within 3 days (30%) incurred the lowest costs and utilization rates, while those who didn’t see a PT at all saw the greatest of both.

Full story at APTA

IOC Recommends ‘Multi-Faceted’ Approach to Pain Management in Elite Athletes

Citing a lack of evidence-based guidelines for managing acute and chronic pain in elite athletes, the International Olympic Committee (IOC) issued a consensus statement (abstract only available for free) recommending a comprehensive, multidisciplinary team approach to address “biomechanics and the kinetic chain continuum, and psychosocial and contextual domains” among elite athletes. It’s an approach that recognizes physical therapists (PTs) as “front-line clinicians who … address conceptualizations of pain and injury.”

While experts suggest nonpharmacologic interventions as first-line treatment, IOC authors acknowledge that “when an athlete has severe acute pain, relief of pain is not only humane but may be necessary to facilitate early mobilization.” Drugs, they state, should be used only as “one component” of a broader plan that could include physical therapy, psychosocial interventions, and, if necessary, surgery.

Full story at APTA

New National Academies Report on Pain Management and Opioids Recommends More Public Education, Reimbursement Models Supporting Nondrug Approaches to Pain Treatment

The recommendations contained in a new National Academies of Sciences, Engineering, and Medicine (National Academies) report on pain management and the opioid crisis are wide-ranging, but a few may sound familiar to physical therapists (PTs), physical therapist assistants (PTAs), and anyone familiar with APTA’s #ChoosePT campaign—namely, the need to support nonpharmacologic approaches to pain treatment through better reimbursement models, and the necessity of continued efforts to educate the public on effective alternatives to opioids.

The positions on reimbursement and public education were among 21 recommendations included in the National Academies’ report titled “Pain Management and the Opioid Epidemic,” a comprehensive document that examines the opioid crisis from multiple perspectives. The overarching theme of the report: if America is serious about solving the opioid crisis, it’s going to require work and change at nearly every level of health care, public policy, and even clinical education.

Full story of public education support for non-drug pain treatment at APTA

Your mind can be trained to control chronic pain. But it will cost you

There was plenty to blame: the car wreck that broke his back. The job pouring concrete that shattered his spine a second time. The way he tore up his insides with cigarettes, booze, cocaine, and opioids.

It all amounted to this: Carl White was in pain. All the time. And nothing helped — not the multiple surgeries, nor the self-medication, not the wife and daughter who supported him and relied on him.

Then White enrolled in a pain management clinic that taught him some of his physical torment was in his head — and he could train his brain to control it. It’s a philosophy that dates back decades, to the 1970s or even earlier. It fell out of vogue when new generations of potent pain pills came on the market; they were cheaper, worked faster, felt more modern.

Full story of training your mind on dealing chronic pain at Stat News

Survey Results Reveal Traction Popular Among PTs Treating Neck Pain

Authors of a new study write that although systematic reviews provide “limited support” for the use of cervical traction to manage neck pain, a recent survey of APTA Orthopaedic Section (OS) members revealed that most physical therapists (PTs) in the section use it, even when it’s a less strongly indicated intervention. They believe that the high rate of use—and the variety of traction methods employed—point to the tendency of PTs to pursue “comprehensive plans of care.”

The study, e-published ahead of print in The Journal of Orthopaedic and Sports Physical Therapy, is based on responses to a survey sent to 4,000 OS members nationwide. A total of 1,001 members responded to the questionnaire, which included 28 open- and closed-ended questions on demographics, adherence to classification criteria for traction, delivery methods used, and additional interventions, as well as 2 clinical scenarios.

Full story of cervical traction to manage neck pain at APTA

Toward a Transformed Understanding: From Pain and Movement to Pain With Movement

Pain serves as a protective mechanism that leads to changes in movement. For more than 116 million Americans with chronic pain, however, the pain experience persists beyond a normal, protective phase and develops into a chronic, disabling disease.3 Altered movement may be appropriate in early protective phases, but, if maintained, this altered movement can contribute to poor recovery, continued disability, and decreased quality of life. The Institute of Medicine identifies chronic pain as a nervous system disease and a high-priority societal health concern. However, current management of this disease and its complications, such as movement impairments and subsequent reductions in function, is inadequate. The Institute of Medicine has called for the health care community to transform its understanding of pain as a key step for improving prevention, treatment, and assessment of pain.

Full story of understanding pain with movement at APTA

It’s Not Just Consumers Who Must Think Differently About Pain

The United States is in the midst of a costly and deadly opioid epidemic. There are no easy answers to this problem, but physical therapists could be a big part of the solution. Physical therapy’s potential for effective pain management has already been recognized by a Centers for Disease Control and Prevention (CDC) initiative indicating that physical therapy should be a front line option for patients with chronic pain conditions. In response, APTA initiated the #ChoosePT campaign to let patients and providers know that physical therapists are a viable early option for pain management.

These are exciting developments, and they bring new opportunities and challenges to our profession. The opportunity is clear: a move away from widespread opioid use could allow more patients with pain to benefit from physical therapy, which offers pain relief that is effective and does not carry the risks associated with opioid use.

Full story of consumers thinking differently about pain at APTA

From Move Forward Radio: Transforming Society’s Understanding of Pain

Andre Machado, MD, chairman of the Neurological Institute at Cleveland Clinic, thinks opioids are remarkable.

“But ‘remarkable’ can have 2 meanings,” he says. “It can be a positive remarkable, or a negative remarkable. And the long-term use of opioids, when we use it chronically, is often remarkable in the wrong direction.”

Now available from APTA’s Move Forward Radio: a conversation with Machado, who is leading an innovative pain treatment research project that puts a combination of physical therapy and behavioral therapy at the front lines of pain treatment, and takes a cautious approach to the use of opioids. Machado shared his thoughts on opioids and the need for a cultural shift on attitudes about pain in a recent TIME magazine opinion piece. His Move Forward Radio interview delves even deeper into his beliefs on what constitutes truly effective pain treatment.

Full story of transforming society’s understanding of pain at APTA

Choose Policies That #ChoosePT: 6 Policy Fixes That Could Improve Access to PTs

The #ChoosePT campaign is helping to call attention to the role physical therapists (PTs) and physical therapist assistants (PTAs) can play in providing consumers with effective, nondrug approaches to pain management.

But winning the battle against opioid abuse will take more than raising awareness—it will also require real change.

Much of that change has to happen around the ways everyone—providers, payers, and patients—view pain and its treatment, but those changes could happen more quickly if a few policies were brought up to speed in ways that would make it easier for the public to access and afford sufficient physical therapy. With improved access comes improved understanding of the real, safe alternative PTs and PTAs offer.

Full story of policy fixes to improve access to PTs at APTA