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An Unexpected Gift: Be Careful What You Ask For, by Jay Shaver

01-Mar-2017 12:46 PM | Anonymous member (Administrator)

The Comprehensive Addiction and Recovery Act (CARA) is now a federal law whose purpose is to advance treatment and prevention measures to reduce opioid use. APTA has jumped on board with the very successful #Choose PT campaign to educate the public, healthcare professionals and state legislators on how PT’s are at the forefront of this effort. Currently, 22 states have used TV Public Service Announcements, with over $1.8 million of donated time and an estimated 146 million potential viewers. Printed public service announcements have appeared in over 950 papers with an estimated viewing by 149+ million Americans.  We are starting up our program in Montana and hope to have the same level of success that other states have enjoyed.

But are we ready for the potential influx of new referrals from the publicity? There were many therapists I visited with in San Antonio at the Combined Sections Meeting a few weeks ago, that were worried about the limited number of physical therapists that have advanced training in pain. Consider the following:

  • ·         20% of the population in developed countries have  an ongoing pain state longer than the traditional tissue healing time (Merskey and Bogdukl 1994; Wall and Melzack 2005)
  • ·         116 million Americans live with chronic pain with management costs of $635 billion/year ((Medicine) 2011).
  • ·         Unfortunately, increasing research on money spent on reducing chronic pain has been ineffective (Deyo, Mirza et al. 2009).

In rehabilitation, there is a growing body of research that suggests our models of explaining pain are outdated (Mosely 2003; Mosesly 2007; Louw and Butler 2011; Nijs, Rousell et el. 2012). The biological model of explaining pain in relationship to tissue and tissue injury that is the cornerstone of traditional pain education has been shown to have limited efficacy and can increase fear in patients ( Green, Appel et al.2005: Morr,Shanti et al.2010.  Using a word such as wear and tear, disc space loss, and deterioration has been associated with a poor prognosis (Sloan and Walsh 2010).

As discussed in the last newsletter, there is good evidence that PT’s can help with pain through exercise, manual therapy, and education. Are we offering quality education to our patients with pain? We get plenty of opportunities to improve our hands on skills, but do we seek out programs that focus on pain? Considering that almost all of our patients in the outpatient setting are dealing with some level of pain, it would appear to be a good idea.

Thanks to Caressa Benjamin, our programs chairperson, you have an opportunity to get the most current education this spring in Whitefish at the Explain Pain education course. The NOI group is recognized worldwide as a leader in pain research and treatment.  This is a great opportunity to improve your knowledge of pain education and treatment.

 Let's continue to work to decrease the use of opiates with treatments that are based on good research. The gift is ours. Let's make sure we use it wisely. 

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