Physical therapy

Physical therapy often better than opioids for long-term pain management

Written by Tony English, PT, PhD, director of the Division of Physical Therapy at the University of Kentucky‘s College of Health Sciences.  

Tony English

Tony English

According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the U.S. since 1999, even though there has not been an overall change in the amount of pain reported.

People with chronic pain conditions unrelated to cancer often depend on prescription opioids to manage their pain. As opioid use has increased, so has the misuse, abuse and overdose of these drugs in Kentucky and across the country.

The statistics are sobering:

  • As many as one in four people who receive prescription opioids long term for non-cancer pain in primary care settings suffer with addiction.
  • Heroin-related overdose deaths more than quadrupled between 2002 and 2014, and people addicted to prescription opioids are 40 times more likely to be addicted to heroin.
  • More than 165,000 people in the United States have died from opioid pain-medication-related overdoses since 1999.
  • Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.

The CDC released guidelines in March urging prescribers to reduce the use of opioids in favor of safer alternatives in the treatment of chronic pain. Physical therapy is one of the recommended non-opioid alternatives.

If you or someone you know has pain not related to cancer, consider physical therapy as a safer alternative for managing your pain. Physical therapists diagnose and treat movement disorders that may be contributing to your pain and will develop an active treatment plan specific to your goals.

A 2008 study following 20,000 people over a period of 11 years found that people who exercised regularly reported less pain. Manual therapy can reduce pain and improve mobility so that people have more pain-free movement. That, in turn, promotes more activity, which reduces pain even further. Exercise and manual therapy are two components of an active treatment plan that may be used by a physical therapist to help manage pain.

The American Physical Therapy Association has launched a national campaign called #ChoosePT to raise awareness about the risks of opioids and the choice of physical therapy as a safe alternative for long-term pain management.


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Preventive exercises have been shown to reduce the risk of ACL injury, and they are becoming increasingly important for young athletes.

Preventive exercises can reduce ACL injuries

Written by Dr. Cale Jacobs, Assistant Professor in UK’s Department of Orthopaedics and Sports Medicine.

Dr. Cale Jacobs, Assistant Professor in UK’s Department of Orthopaedics and Sports Medicine.

Dr. Cale Jacobs

Unfortunately, each year, about 7 million sports-related injuries occur in the U.S. Approximately half occur in people between the ages of 5 and 24 years old. Injuries, especially to the knee, remove young athletes from the playing field and can have long-term repercussions that limit mobility and lead to more severe issues.

Tearing the anterior cruciate ligament (ACL), the tough band of tissue joining the thigh bone and shin bone at the knee joint, is not uncommon in “cutting” sports like soccer, volleyball, football and basketball. An ACL tear is a particularly damaging injury as it often leads to knee arthritis, and studies have reported that 50 percent of people who tear their ACL develop arthritis within 15 years of their injury. When you consider that most ACL injuries happen to those under the age of 25, this means that many patients are developing knee arthritis in their 30s or early 40s.

The ACL can be surgically reconstructed, which improves the stability of the knee. However, for young female athletes playing in cutting sports after ACL reconstruction, roughly one in three of these athletes will suffer a second ACL injury. Also, recovery after ACL reconstruction differs from patient to patient, with some taking longer to safely return to sports.

Because of the high rate of early knee arthritis and the risk of a second injury, preventing the first ACL injury is crucial. Preventive exercise programs have been shown to reduce the risk of ACL injury, and the free Get Set-Train Smarter app available on Android and iOS is a great resource for parents and athletes. This app, created by the International Olympic Committee, enables athletes to select an exercise program that is specific to the sports they play.

In addition, UK researchers are studying a number of ways to prevent a second ACL injury as well as prevent or delay the onset of knee arthritis for younger athletes that suffer an ACL injury. These include injections to lessen cartilage damage, improved surgical techniques for younger athletes and innovative rehabilitation protocols like one’s being used with injured NFL athletes. Current research has also identified that athletes still have sizeable muscle imbalances when they return to sports, suggesting that both improved rehabilitation protocols and better testing methods be used to safely return young athletes back to their sport.


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