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Physiotherapy helps prevent and manage pain

  • Physiotherapy reduces reliance on opioids to manage pain.
  • Physiotherapy exercise rehabilitation can reduce pain and disability, as well as improve quality of life for patients with musculoskeletal pain.
  • Physiotherapy effectively treats and reduces lower back pain, osteoarthritis, and other musculoskeletal pain conditions.
  • Timely and appropriate access to physiotherapy can reduce reliance on publicly funded health care services and medications to manage pain.

Assessment and management of pain

Assessment and management of pain is a fundamental aspect of physiotherapy practice.1 There is strong evidence that chronic pain is most effectively managed using non-pharmacological strategies, such as activity, exercise, and mental health supports.2 Despite this evidence, access to these therapies remains a significant barrier to many Canadians living with chronic pain.2 The estimated combined direct and indirect costs of chronic pain in Canada total between $56 and $60 billion per year3 – a cost that is greater than the estimated costs of cancer, heart disease, and HIV combined.4

Pain is complex

It is important to recognize that pain is complex, and that managing and treating chronic pain is not the responsibility of any single health profession or type of intervention – be it pharmacological, psychological, or activity-based rehabilitation. The Canadian Pain Task Force, created by the federal government in 2019, continues to provide recommendations to government on how to better respond to the needs of Canadians living with chronic pain.5 By increasing funded access to physiotherapists as part of a comprehensive pain management team of health professionals, we can help take a stronger approach to supporting Canadians living with pain.

Physiotherapy as a component of patient-centred primary care

Physiotherapy, as a component of patient-centred, primary care, can help provide patients with the resources, knowledge and education they need to be successful in self-management strategies to live with and manage their pain. When neither improvement nor even maintenance of functional mobility is a reasonable goal, physiotherapists can contribute to helping older people to remain comfortable and pain-free. Integrating physiotherapy into management of acute and chronic pain yields strong health outcomes and reduces costs.

  • Physiotherapy, as part of an interdisciplinary approach to pain management, reduces reliance on opioids to manage pain.6
  • Patients with musculoskeletal conditions (MSK), such as arthritis and trauma, can reduce and/or eliminate pain, muscle weakness, and loss of stability through physiotherapy assessment and treatment, as an alternative to pain medication.7,8
  • Exercise therapy, as a physiotherapeutic rehabilitation intervention, reduces pain and improves activities of daily living in patients with musculoskeletal pain.9
  • Physiotherapy for patients with low back pain is highly effective in reducing acute and chronic pain, improving physical function, decreasing wait times, promoting a healthier lifestyle and independent living, and limiting the risk of increased disability and chronic conditions.10
  • Timely and appropriate physiotherapy care at the community level can reduce the burden on the health care system by decreasing the need for medications and fully publicly funded institutional care.

References:

[1] Johnson, H. & Thériault, E. (2016). Unique Considerations for Management of Pain in the Older Adult. Retrieved from https://physiotherapy.ca/unique-considerations-management-pain-older-adult-johnson-h-theriault-e

[2] Canadian Pain Task Force, Government of Canada (2020, October). Working together to better understand, prevent, and manage chronic pain: What We Heard. Retrieved from https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2020.html

[3] Wilson, M.G., Lavis, J.N., & Ellen, M.E. (2015, September-October). Supporting chronic pain management across provincial and territorial health systems in Canada: Findings from two stakeholder dialogues. Pain Research & Management, 20(5), 269-279. doi: 10.1155/2015/918976

[4] Lynch, M.E. (2011, March-April). The need for a Canadian pain strategy. Pain Research & Management, 16(2), 77-80. doi: 10.1155/2011/65461

[5] Canadian Pain Task Force, Government of Canada. (2019). Canadian Pain Task Force | About. Retrieved from https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force.html

[6] National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse; Phillips, J.K., Ford, M.A., & Bonnie, R.J., editors. (2017, July 13). Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington (DC): National Academies Press (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK458655/

[7] Canadian Physiotherapy Association. (2012). The Value of Physiotherapy | Musculoskeletal Conditions [PDF file]. Retrieved from https://physiotherapy.ca/sites/default/files/valuePT/cpa_valuept_musculoskeletal-en.pdf

[8] Centers for Disease Control and Prevention. (2016, March 18). CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. Morbidity and Mortality Weekly Report, 65(1), 1–49. doi: 10.15585/mmwr.rr6501e1

[9] Lorås, H., Østerås, B., Torstensen, T. A., & Østerås, H. (2015, May 25). Medical Exercise Therapy for Treating Musculoskeletal Pain: A Narrative Review of Results from Randomized Controlled Trials with a Theoretical Perspective. Physiotherapy research international, 20(3), 182–190. doi: 10.1002/pri.1632

[10] Canadian Physiotherapy Association. (2012). The Value of Physiotherapy | Joint Arthoplasty [PDF file]. Retrieved from https://physiotherapy.ca/sites/default/files/valuePT/cpa_valuept_jointarthroplasty-en.pdf

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