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  • Surgeon General Letter Urges Action on Opioids, Recommends CDC Treatment Guideline That Includes Physical Therapy

    Physicians across the United States can expect something in their mailboxes soon—a letter from the Office of the US Surgeon General urging them to take part in the battle against the opioid epidemic, accompanied by a card that specifically mentions physical therapy as one of the preferred first-line approaches for treatment of chronic pain.

    "Everywhere I travel, I see communities devastated by opioid overdoses," writes Surgeon General Vivek Murthy, MD. "I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure."

    In the letter, Murthy asks physicians to sign a pledge at www.TurnTheTideRx.org, the surgeon general's initiative to stem the opioid abuse epidemic.

    Murthy also asks doctors to review an enclosed pocket card that contains the basics of the US Centers for Disease Control and Prevention (CDC) opioid prescription guideline. That guideline lists physical therapy as among the preferred options for the treatment of chronic pain without the use of opioids. Murthy calls the CDC guideline a "good place to start" toward better physician education on how to treat pain "safely and effectively."

    A CNN report on the letter includes Murthy's remarks during a speaking engagement, in which he described how many physicians were taught that opioids are not addictive. Some continue to believe that false information, Murthy told the audience, including 1 of his own physician friends—until Murthy informed him otherwise. He was taught that opioids aren't addictive so long as a patient is "truly in pain," Murthy said.

    "Years from now, I want us to look back and know that, in the face of a crises that threatened our nation, it was our profession that stepped up and led the way," Murthy writes in the letter.

    APTA has added its voice to the effort to curb opioid abuse through its national #ChoosePT campaign, an initiative to promote physical therapy as a safe and effective alternative to the use of opioids in the treatment of pain. Housed at MoveForwardPT.com/ChoosePT, the #ChoosePT campaign will unfold throughout 2016 and include national online advertising, TV and radio public service announcements, and other targeted advertising and media outreach. APTA is also a member of the White House’s working group addressing the opioid epidemic.


    • Do you think that a method of treatment for low back pain that can provide immediate relief of the problem would help to decrease the use of opioids? Incidence: Shaw, orthopedic surgeon at the Topeka Back and Neck Center, did a study of 1,000 consecutive patients with low back pain and found that 98% had this dysfunction. His surgical rate for herniated discs dropped to 0.2%. Shaw, JT: The role of the sacroiliac joint as a cause of low back pain and dysfunction. In: Vleeming A, Mooney V, Snijders CH, Dorman T(eds): First Interdisciplinary World Congress on Low Back Pain and its Relation to the Sacroiliac Joint. San Diego, CA November 5-6, 1992, pp 67-80

      Posted by Richard DonTigny, PT on 8/31/2016 6:31 PM

    • The Cadallac treatment to reduce the use of ophiods in the treatment of Low Back Pain is teh Mckenzie Method-Mechanical Diagnosis and Therapy. Through a proper assessment and proper classificaton of the problem-be it a derangement, dysfunction or postural syndrome-using the appropriate loading strategies with Centralization and a Directional preference of movement of the Lumbar Spine as your treatmetn guide, you can rule out with in 5-7 visits whether or not they will be a responder to this approach. Dr. Ron Donaldson wrote a book on the treatment of nonspecific LBP and demonstrated with the research he quoted in this book, that the MDT Approach is the best way to assess nonspecific LBP and determine that if it is a mechanical Low back problem, then a movement or position will most likely reduce this problem without the use of ophiods which willnot help a mechanical Low Back problem. If it is not a LB problem, then you assess for an SI or hip joint problem. Understandng the pain response to movements or positioning-one can determine the proper diagnosis and proper treatment for that disorder. For moer information on teh McKenzie Method-check: meckenizieinstitue.org

      Posted by Gerald D. Pica on 8/31/2016 11:26 PM

    • I'm glad to see this initiative to reduce the use of such strong medications. I once treated a 16 yo who was prescribed a muscle relaxer, hydrocodone and a sleep aid. She could barely function let alone participate in therapy.

      Posted by Kathleen Laboray PT, MHS on 9/1/2016 9:51 AM

    • Interesting to read Kathleen's message about the ability to participate in therapy. Also interesting to note that some sources say that the continued use of the opiates actually increases susceptibility to pain over time. This could certainly throw a monkey wrench in meeting PT goals of reducing pain.

      Posted by Barb Cook on 10/4/2016 5:50 PM

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