Encouraging Patients to Consider Alternative Pain Treatment Options

The American Physical Therapy Association (APTA) is a professional organization that represents more than 100,000 physical therapists, physical therapist assistants and students of physical therapy. APTA seeks to transform society by optimizing movement to improve the human experience. To learn more about how APTA improves pain management by promoting physical therapy over prescription opioids, Allied Against Opioid Abuse (AAOA) interviewed Senior Practice Specialist Hadiya Green Guerrero, PT, DPT, and Senior Payment Specialist Alice Bell, PT, DPT.


AAOA: What is the #ChoosePT campaign and why is it important for patients to consider an alternative to prescription opioids?

APTA: The #ChoosePT campaign was started to encourage patients to explore alternatives for pain relief outside of prescription opioids. Since then, it has evolved to address other topics important to consumers. As it relates specifically to pain, APTA is engaged in shifting the way we think about pain and options for pain management. Physical therapy is one option and we encourage in-depth conversations about whether that is the best option for you. At times pain is a symptom, but, in some cases, pain can become the primary issue or problem. Helping patients gain a better understanding of their pain and how they can be active participants in the management of their pain helps us move toward better recovery and resumption of prior activities.


AAOA: How do physical therapists work with healthcare providers across the system to improve patient care?

APTA: Our role as physical therapists is unique. Physical therapists are experts in movement and use the latest evidence to design treatment plans for each person’s individual needs, challenges and goals to improve mobility, manage pain and other chronic conditions, recover from injury and prevent future injury and chronic disease.

When you are talking about patients with chronic pain, depending on where they are in their journey, there may be physical, emotional or psychological aspects that need to be addressed. Whether physical therapists are practicing in facilities with primary care providers or working independently, we always collaborate with the care team about the patient’s progress and ensure that all aspects of care are being addressed effectively.


AAOA: APTA has conducted and contributed to a lot of research on prescription opioids and alternative pain treatment options. Could you summarize that research and some of the findings? 

APTA: We have been involved in two bodies of research. The first is research that has been around for a very long time and has studied pain science and improved our understanding of how to treat patients with pain depending on the type of pain they are experiencing. The second is studying the effectiveness of physical therapy compared to prescription opioids. For instance, when a patient has lower back pain, research has shown that opioids are not effective to support function or return to work. Although opioids are often introduced first, they may not be the best first choice for many patients. If we can avoid an opioid prescription and look at other procedures, like physical interventions that address underlying issues, then we can save individuals from being exposed and shorten the episode of care and ensure they will actually achieve a full functional recovery.

We also are exploring creative options for benefit design so that the structure of policies is not a barrier to patients receiving physical therapy. Too often, we see prescription opioids as the low-cost option, but now that society understands the risks associated with those medicines, we would like to address the inequities in benefit design and make it easier for patients to participate in physical therapy for ailments like lower back pain.


AAOA: How has COVID-19 impacted the way physical therapists deliver care to patients?

APTA: Since the beginning of the pandemic, we have encouraged physical therapists to use their professional judgment to determine when, where and how to provide care.

We also have been a longtime advocate for physical therapists and physical therapist assistants providing services via telehealth — the use of electronic information and telecommunication technologies to remotely provide healthcare information and services — but COVID-19 has quickly changed the landscape of telehealth and other communication technology-based services. We are educating our members about the regulations and processes related to telemedicine through the Coronavirus (COVID-19) Resources for the Physical Therapy Profession section of our website.


AAOA: What is your message for patients who have been prescribed opioids to manage pain or for families of people who have been prescribed opioids?

APTA: The opioid epidemic forced the healthcare system in the United States to think about how we talk about pain and engage individuals and give them greater control over management of their condition. Unfortunately, we had to get to a significant place before there was a strong response. We won’t miss the chance to really explore that journey and encourage patients to discuss alternatives to prescription opioids with their healthcare provider. Some patients will need a prescription drug to manage pain. But for other patients, there are ways to manage pain without the risks associated with prescription opioids or other pharmacologics.