Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management

According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though "there has not been an overall change in the amount of pain that Americans report."

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed.

But for other pain management, the CDC recommends nonopioid approaches including physical therapy.

Patients should choose physical therapy when ...

• ... The risks of opioid use outweigh the rewards.
  Potential side effects of opioids include depression, overdose, and addiction, plus withdrawal symptoms when stopping opioid use. Because of these risks, "experts agreed that opioids should not be considered firstline or routine therapy for chronic pain," the CDC guidelines state. Even in cases when evidence on the long-term benefits of non-opioid therapies is limited, "risks are much lower" with non-opioid treatment plans.
• ... Patients want to do more than mask the pain.
  Opioids reduce the sensation of pain by interrupting pain signals to the brain. Physical therapists treat pain through movement while partnering with patients to improve or maintain their mobility and quality of life.
• ... Pain or function problems are related to low back pain, hip or knee osteoarthritis, or fibromyalgia.
  The CDC cites "high-quality evidence" supporting exercise as part of a physical therapy treatment plan for those familiar conditions.
• ... Opioids are prescribed for pain. 
  Even in situations when opioids are prescribed, the CDC recommends that patients should receive "the lowest effective dosage," and opioids "should be combined" with nonopioid therapies, such as physical therapy.
• ... Pain lasts 90 days.
  At this point, the pain is considered "chronic," and the risks for continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are "preferred" for chronic pain and that "clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient."

Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment.

"Given the substantial evidence gaps on opioids, uncertain benefits of long-term use and potential for serious harm, patient education and discussion before starting opioid therapy are critical so that patient preferences and values can be understood and used to inform clinical decisions," the CDC states.

Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids.

Physical Therapy Journal (PTJ) Special Issue Highlights Effectiveness of Nonopioid Approaches to Pain

ALEXANDRIA, VA, April 16, 2018 — Early utilization of physical therapist treatment can reduce opioid use and downstream health care costs. That's just one important takeaway from the latest edition of Physical Therapy (PTJ), the official scientific journal of the American Physical Therapy Association (APTA), which today published a special issue devoted to nonpharmacological pain management. 

In five original research papers released online ahead of print for the May special issue:

• Patients who received physical therapist treatment immediately following arthroscopic hip surgery were associated with lower downstream costs and lower opioid use.
• People treated by a physical therapist within three days of the onset of low back pain were associated with lower total health care costs and lower opioid use.
• Telehealth physical activity programs for older adults with low back pain improved physical function.
• Analysis of patient screening suggested it may be possible to predict which patients are at risk for long-standing musculoskeletal pain.
• Patient education about pain's link to the brain improved the participation of patients with chronic spinal pain in beneficial physical activity programs.

"This special issue adds new evidence to a growing body of evidence on the important role of nonpharmacological interventions for the management of chronic pain," said Editor in Chief Alan M. Jette, PT, PhD. "The need for this information has never been so urgent."

According to the American Academy of Pain Medicine, 100 million Americans live with chronic pain, and many of them turn to opioids to manage it. The Centers for Disease Control and Prevention (CDC) recommends pursuing nonopioid options like physical therapy for the safe management of chronic pain. Physical therapists treat pain through prescribed movement and exercise, hands-on care and patient education.

APTA's #ChoosePT campaign raises awareness about the risk of opioids for long-term pain management and physical therapy as a safe and effective alternative, consistent with CDC guidelines.

The American Physical Therapy Association represents more than 100,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. Visit MoveForwardPT.com to learn more about the types of conditions physical therapists treat, and find a physical therapist in your area.

Source: APTA

Eppie's Great Race 7.21.18

The family got together to participate in the final running of Eppie's Great Race.  We had a great time.  

4 Tips to Stay Active and Independent As You Age→

 

Aging can have a bad reputation; however, there is no reason that growing older can’t be a journey full of adventure and opportunities to live life to the fullest. All you need is proper guidance, proactive steps, and a positive attitude.

And there is proof. Research suggests that improvements in physical function are possible well into older adulthood, and supports that continued activity as you age helps fight cognitive decline.

With the guidance of a physical therapist, you can improve mobility, maintain your independence, and continue participating in your favorite daily activities. As a movement expert, a physical therapist can provide an evaluation and design a treatment program to address any of your ailments and deficiencies, make modifications based on other preexisting conditions, and help you achieve your goals.

The following tips can keep you active and independent as you age:

1. Staying fit. Whether you are participate in regular exercise or just want to stay fit for daily activities, exercise is necessary. Exercise is proven to help improve balance, strengthen bones, and prevent heart and brain conditions. A prescribed strength training and aerobic exercise program will help you maintain and strengthen critical muscle groups needed for your life.
2. Staying balanced. Maintaining balance and avoiding falls are imperative to maintaining a quality of life and living independently. A physical therapist can prescribe a customized program of static and dynamic balance activities and exercises to improve your balance and prevent dangerous falls.
3. Assessing the terrain. A physical therapist can make recommendations that make your home and other environments safe by eliminating dangerous barriers. Typically this means removing throw rugs, loose carpets, clutter, and modifying entry thresholds with ramps.
4. Staying engaged. Successful aging is not only impacted by one’s environment, but also how one interacts with their environment. Fear and social isolation are substantial factors that increase fall risk and jeopardize independence. To ensure active and successful aging, continue to engage with friends, family, and the community. Social experiences with friends and family help diminish fear and improve physical and mental capabilities.

References

Stephens C, Breheny M, Mansvelt J. Healthy ageing from the perspective of older people: a capability approach to resilience. Psychol Health. 2015;30(6):715–731. Article Summary in PubMed.

Avin KG, Hanke TA, Kirk-Sanchez N, et al. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815–834. Free Article.

Young WR, Mark Williams A. How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations. Gait Posture. 2015;41(1):7–12. Free Article.

Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLOS Med. 2010;7(7):e1000316. Free Article.

Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–2243. Article Summary in PubMed.

Moreland J, Richardson J, Chan DH, et al. Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology. 2003;49(2):93–116. Article Summary in PubMed.

House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241(4865):540–545. Article Summary in PubMed.

 Authored by Joseph V Libera, PT, DPT, MBA, MPH, GCS

Article Source:  Move Forward PT

Role of a Physical Therapist

Physical therapists (PTs) are health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives.

PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

Physical therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a physical therapist practices.

The Physical Therapy Profession

Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists:

• Diagnose and manage movement dysfunction and enhance physical and functional abilities.
• Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
• Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.

The terms "physical therapy" and "physiotherapy," and the terms "physical therapist" and "physiotherapist," are synonymous.

As essential participants in the health care delivery system, physical therapists assume leadership roles in rehabilitation; in prevention, health maintenance, and programs that promote health, wellness, and fitness; and in professional and community organizations. Physical therapists also play important roles both in developing standards for physical therapist practice and in developing health care policy to ensure availability, accessibility, and optimal delivery of health care services. Physical therapy is covered by federal, state, and private insurance plans. Physical therapists' services have a positive impact on health-related quality of life.

As clinicians, physical therapists engage in an examination process that includes:

• taking the patient/client history,
• conducting a systems review, and
• performing tests and measures to identify potential and existing problems.

To establish diagnoses, prognoses, and plans of care, physical therapists perform evaluations, synthesizing the examination data and determining whether the problems to be addressed are within the scope of physical therapist practice. Based on their judgments about diagnoses and prognoses and based on patient/client goals, physical therapists:

• provide interventions (the interactions and procedures used in managing and instructing patients/clients),
• conduct re-examinations,
• modify interventions as necessary to achieve anticipated goals and expected outcomes, and
• develop and implement discharge plans.

Physical therapy can be provided only by qualified physical therapists (PTs) or by physical therapist assistants (PTAs) working under the supervision of a physical therapist.

Source: Guide to Physical Therapist Practice, 2nd Edition (2003)

Vision Statement for the Physical Therapy Profession

"Transforming society by optimizing movement to improve the human experience." Learn more about APTA's plan for the future of the physical therapy profession.

Courtesy of the American Physical Therapy Association and MoveForward PT

Article source: http://www.apta.org/PTCareers/RoleofaPT/

Pro Dynamic Physical Therapy Featured in Style Magazine

2016 have been an incredible year for Pro Dynamic Physical Therapy. We have enjoyed serving the communities of Granite Bay, Folsom and Roseville since opening our doors in March. Check our our featured piece in Style Mag's 'Welcome to the Community'. Get an idea of why PDPT Inc. was started and a couple other random facts about the owner.

Pro Dynamic Physical Therapy Ribbon Cutting Ceremony June 16th

We invite you to come meet our physical therapy team, get a first-hand look at our newly renovated facility and enjoy refreshments throughout the event! See flier for more details! 

Open House 3:30 - 5:30pm

Ribbon Cutting 4:00pm

6955 Douglas Blvd - Granite Bay, CA - 95746

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