When you have severe pain all you want is relief, so what do you do? Most people’s first move is to see their medical doctor. This is great, as they can assess your pain, order imaging if needed and educate you about your options for relief. In my experience as a physical therapist, by the time patients have gotten referred to me they have usually been prescribed some sort of pain medication, muscle relaxer or steroid. I have no problem with this, as sometimes people really do need something to dull their pain so that they can lead a somewhat normal life. My biggest issue is that most of the time I am seeing people weeks to months and sometimes YEARS after their pain started. My biggest qualm with this is that pills are just bandaids – whether they be pain relievers, muscle relaxers or anti-inflammatories. They do not fix the source of the pain, they purely mask the symptoms or knock you out so that you don’t feel the pain. They can be beneficial to help people sleep, or immediately after surgery, but I am often seeing people that have been taking these medications for very prolonged periods of time.
Opioids are a group commonly prescribed narcotic pain medication. They have been shown in the research to be extremely addictive and if taken over a prolonged period of time, that chance of addiction rises drastically. The body also accommodates to the medications, so over time people have to take more medication or find something stronger. In the past year I have noticed that doctors are really trying to regulate the amount of pain medications that patients are taking. This is great, but the only problem with this is that once someone is addicted, they will find whatever they need in order to maintain their pain control or to get that high that they have become accustomed to. Unfortunately, many people that have become addicted to opioids are turning to heroin, which is very scary! In both cases, it is extremely easy to overdose, especially if you’ve tried quitting but then are pulled back by the call of the addiction. SCARY STUFF!!
Physical therapists, chiropractors, acupuncturists and massage therapists (just to name a few) are an amazing group of “conservative” medical providers that can be a part of an amazing medical team. To me, conservative means that they do not prescribe medication or perform surgery. Some may prescribe certain herbs, topical analgesics or other non-opioid “medications.”
As a physical therapist, my main goal is to find the source of the pain – whether it be musculoskeletal (muscle spasm, joint mobility issues, poor posture, weakness, flexibility imbalance, etc), neurological (sciatica, numbness and tingling, radiating pain, etc) and if there is a component of emotional, hormonal, nutritional or other imbalances. I look at the whole body – this is considered holistic medicine. Many times it can be something relatively simple that requires decreasing the inflammation and prescribing a few exercises, or it may be more complex and require a team of healthcare professionals. The great thing about most conservative medical providers is that we will refer patients to another specialist if we feel that they will benefit more from other treatment techniques or if their condition is not within our scope of practice. Therefore, the patient will receive the best care possible and avoid being stuck in the system and given more and more medications.
In conclusion – if you have pain, sustain an injury, are having trouble with balance or weakness, or want to prevent injury, see a conservative medical provider within the first few days! We can decrease the initial pain and inflammation and show you ways that you can help yourself to feel better, shorten the duration of your symptoms and give you the knowledge of how to improve yourself and prevent future injury. Initially, pain medication may be necessary; but the sooner you get to a conservative medical provider, the sooner you can get off the pain meds and return back to an improved quality of life.