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Working Through the Pain: APTA Continues to Work for Expanded Patient Access to Physical Therapy for Pain Management


Pain Awareness Month, observed each September, is an opportunity to raise public awareness about pain and nonpharmacologic pain management. The opioid crisis has shed a spotlight on the health care community's collective failure to adequately support individuals in adopting safe and effective pain management strategies. As a result, the subject of pain and pain management is one that continues to be at the forefront of health care policy discussions.

The American Physical Therapy Association has been actively involved for some time in efforts to raise the awareness of the public, the health care community, legislators, regulators, and payers about the role of physical therapists and other providers in pain management. While acknowledging that pharmaceutical intervention, including opioids, has a role in pain management for certain types of patients, APTA continues to advocate for patient access to the most appropriate care for their condition with the least level of risk and the opportunity for the best outcome. These efforts have resulted in positive changes impacting patients who are seeking care for the treatment of musculoskeletal pain or for conditions that cause pain.

To wrap up Pain Awareness Month, here are some of the ways APTA has contributed to advancing understanding of, and access to, nonpharmacologic approaches to pain management.

Participating in state advisory boards to develop policy recommendations regarding pain management. APTA members have contributed their expertise to numerous state-level efforts to address opioid misuse. This has led to required insurance coverage of physical therapy for chronic pain, lower cost sharing for patients, establishment of prescriber and patient education on nonpharmacologic treatment to manage pain, and the development of workgroups to evaluate the impact of these efforts. As a result of APTA and chapter advocacy, several states have adopted changes in Medicaid policy that provide for access to and payment for physical therapist (PT) services to address pain management.

Influencing federal regulatory decisions on patient access to physical therapy for pain. APTA continues to meet with legislators and agency representatives on this topic and has submitted comments on federal proposals related to pain management, including the US Department of Health and Human Services (HHS) request for information on ensuring patient access and effective drug enforcement and a federal Pain Management Best Practices Inter-Agency Task Force draft report. In addition, APTA maintains a formal collaborative partnership with the Department of Veterans Affairs to promote veterans' access to nonpharmacologic approaches to pain management.

Providing expertise to guide public policy on pain management. APTA has participated in several national committees and work groups to provide recommendations on pain management, including the National Academy of Medicine (NAM) Action Collaborative on Countering the US Opioid Epidemic and the National Quality Partnership Opioid Stewardship Member Network. The latter group will expand on the work of the National Quality Partnership Opioid Stewardship Workgroup, which produced the National Quality Partners Playbook on Opioid Stewardship.

In addition, APTA produced a white paper on reducing opioid use, "Beyond Opioids: How Physical Therapy Can Transform Pain Management to Improve Health (.pdf)."

Promoting commercial payer benefit design changes. Based on findings from a joint study with APTA and OptumLabs, United Healthcare is piloting policy changes to its pain management program, including elimination of cost sharing for an initial PT visit and promoting early and direct access to physical therapy for patients with low back pain. Two follow-up studies found that fewer restrictions on provider choice and lower patient cost sharing led to higher use of physical therapy for low back pain and that patients with low back pain who initially visited a PT were substantially less likely to use opioids.

Advancing interprofessional education on physical therapy and pain management. APTA collaborates with the International Association for the Study of Pain (IASP) in the development of its Curriculum Outline on Pain for Physical Therapy interprofessional pain curriculum and creation of courses on the integration of the IASP curriculum into physical therapist professional education curricula.

APTA's Opioid Awareness Initiative. APTA's award-winning initiative continues to reach out to consumers to educate them about physical therapy's role in safe pain management. Most recently, APTA has transitioned the consumer website MoveForwardPT.com to ChoosePT.com. The site includes the Find a PT directory, symptoms and condition guides, health tips, podcasts, and more.

For more information on the role of physical therapists in pain management, go to www.choosept.com.


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