Prescription opioid medications were once thought to be safe and effective methods used to address acute and chronic pain. We now know that there is much more to the story. Even short-term use of these medications is not always effective, and may be associated with serious risks.
Unfortunately, the use of prescription opioids has grown to a crisis level in our country. Canada is the second largest, per-capita user of prescription opioids in the world, bringing us to a situation that is a national public health crisis.
While many factors have brought us to this point, lack of access to non-medicated pain management is an important contributor. Research evidence tells us that this form of pain management must be built into every effort aimed at improving the current situation.
Here’s just a sample of what the evidence says:
- When patients seek a physiotherapist first for their musculoskeletal pain, the prescription of opioids is significantly reduced.
- Even conservative physiotherapy treatments for musculoskeletal pain offer similar or better outcomes than opioids and eliminate the risk of negative side effects.
- Using physiotherapy as a triage for patients with musculoskeletal pain reduces inappropriate referrals to specialists, expensive imaging, and emergency room visits.
As a physiotherapist, I understand that pain management is a complex issue. I also understand that interdisciplinary care is essential for managing pain, particularly complex or chronic pain. I value research evidence as a key driver for meaningful solutions, especially when it comes to public health. The evidence is undeniable: physiotherapy services are a proven non-pharmacologic method for reducing pain and improving function.
Let’s renew and integrate physiotherapy and other rehabilitation services into publicly funded community, home-based, and other primary care settings. Let’s ensure that Nova Scotians have access to the best services available so that a customized treatment plan that is safe, effective, affordable, and not addictive is our first line of defence against pain.
Piaf Des Rosiers, PT
President-Elect, Nova Scotia Physiotherapy Association