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Chasing the Dragon: Driving the Paradigm Shift to Move Beyond Opioids
The Journal of Orthopaedic and Sports Physical Therapy
|December 1, 2020
Summary
Americans expect quick pain relief, worsening the opioid crisis. Prioritizing exercise and physical rehabilitation as first-line treatments can reduce reliance on opioids and save lives.
Area of Science:
- Orthopedics
- Sports Medicine
- Pain Management
Background:
- The United States faces a severe opioid crisis, partly due to a cultural expectation of immediate, physician-administered pain relief.
- Pharmaceuticals offer symptomatic relief but do not address the root causes of injuries or chronic musculoskeletal conditions.
- Current guidelines recommend exercise therapies over passive care for chronic pain management.
Purpose of the Study:
- To advocate for exercise and physical rehabilitation as the primary, lowest-cost, first-line treatment for pain management.
- To emphasize the integration of guided physical rehabilitation into stepped-care pain management protocols.
- To highlight the potential of exercise-based self-care to mitigate the opioid crisis.
Main Methods:
- This study is a perspective piece, analyzing the current approach to pain management.
- It reviews existing guidelines and the efficacy of exercise therapies versus passive care.
- It discusses the implications of a shift towards exercise-first pain management.
Main Results:
- Regular exercise is associated with reduced pain.
- Exercise therapies are recommended over passive care for chronic pain.
- Guided physical rehabilitation, integrated early into stepped care, is linked to reduced high-cost services and opioid use.
Conclusions:
- Self-care approaches centered on exercise represent a logical, cost-effective, first-line treatment strategy for pain.
- Incorporating guided physical rehabilitation early in pain management can decrease healthcare costs and opioid dependence.
- A cultural shift away from first-line pharmaceutical pain management towards exercise is crucial to address the opioid crisis and save lives.
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