2013-09-04 / Front Page

Physical therapy offers a safe and effective alternative to drugs in treating low back pain

By Michael Sheynin P.T.

A n investigative report published in 2008 in the New York Times highlights the alarming increase in methadone prescriptions for the treatment of chronic spinal pain.The result has been a shocking increase in methadone-related deaths. Methadone was once limited to use in addiction treatment centers to replace heroin, but today it is frequently given out by physicians to manage spine and joint pain. The Drug Enforcement Administration noted that from 1998 to 2006, the number of methadone prescriptions increased by 700 percent. Other medications such as oxycodone (Percocet when combined with acetominophen) and hydrocodone (Vicodin when combined with acetominophen) also have various serious side effects and are highly addictive. A February 2008 report published in the Journal of the American Medical Association reports that from 1997 to 2005, pharmaceutical expenditures for the management of low back pain increased by 171 percent while the rate of good outcomes fell. “All the imaging we do, all the drug treatments, all the injections, all the operations have some benefit for some patients,” said Richard A. Deyo, a physician at Oregon Health & Science University in Portland and a co-author of the report. “But I think in each of those situations we’ve begun using those tests or treatments more widely than science would really support.” Patients should be aware that these medications are not the best option to reduce the symptoms of spinal pain. Research has shown that early movement and treatments like exercise and manual therapy offer strong benefits to people suffering from spinal pain and disability.

Whether low back pain is a result of an injury or arthritis, patients invariably enter a vicious cycle: pain – fear of movement - loss of movement – muscle spasms - decreased mobility – abnormal posture - more pain.

Properly done and initiated early, physical therapy breaks this cycle, decreases pain and reestablishes normal movement. Physical therapists are highly trained professionals who have a variety of tools to deal with a variety of injuries and painful conditions including low back pain. Among these tools are therapeutic ultrasound, infrared therapy and electric stimulation, all of which have been shown to effectively reduce pain, especially in the acute stages of injury. Manual therapy is a very important and effective tool that physical therapists use to eliminate pain and spasms and restore normal movement.Very specific therapeutic exercises are used when the initial pain subsides and the patient needs to get back to their normal activities of daily living.A properly structured and supervised exercise program is extremely important for complete recovery and prevention of reoccurrence.

Perhaps the most important (and often overlooked) aspect of physical therapy is education. Physical therapists teach people how to take care of themselves. We are all familiar with the saying “If you give a man a fish, he eats for a day. If you teach him how to fish, he eats for the rest of his life.” In this sense, physical therapists are like fishing instructors.

While there is no one solution to pain, physical therapy can be highly effective and is certainly the safest and most conservative form of treatment. If you suffer from low back pain or other injury, get your life back and let physical therapy lend you a helping hand.

Michael Sheynin is a physical therapist and a co-owner of Free Motion Rehabilitation Center in Howell. He can be reached at 732- 901-8844. For more information, visit www.freemotionrehab.com.

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