BOSTON - Amid the widespread damage caused by the nation's opioid crisis, more and more doctors are looking into alternatives to prescribing pain medication.
For some doctors, the answer to the opioid crisis might partially be found in manual medicine, or treating the source of physical pain with physical therapy, as opposed to medication
It seems like a no-brainer to go fix the source of someone's pain before prescribing them pain medication, but that's not usually the solution offered because it's not an "easy fix."
Of course, it depends on the patient's source of pain, what other kinds of treatments are available and if they have just undergone surgery.
For people like Michele Daniels, who was caught in a car accident three months ago, physical therapy was prescribed instead of opioids.
"I have pain that radiates from my lower back here all the way to the back of my leg," said Daniels. "I’m in pain right now."
In many cases, patients with chronic injury turn to opioids to help curb their pain but end up getting addicted after months of being on the pills.
"You have your acute injury where someone initially gets hurt or a chronic injury where someone is dealing with pain for six months or a year and it’s not uncommon for someone to get hooked on medication to try and help with the pain," said Stephen Minard, of the Dedham Health & Athletic Complex.
That addiction, in turn, fuels the illicit drug market once patients are taken off prescribed pills. Many turn to the streets, such as places like Methadone Mile, for drugs to supply their addiction.
According to Orthopedic Surgeon John Tierney, drugs are a last resort because they don't really take the pain away, they just mask the symptoms.
"You cannot just write a prescription and get them out the door," said Dr. Tierney. "Solve the problem, solve the pain generator. The cause of the pain and the pain goes away."
As for alternative therapies, Dr. Tierney says there are several options out there, tailored to help patients with varying degrees of pain.
"There is physical therapy, it could be acupuncture, there is traditional osteopathic methods, etc," said Dr. Tierney. "I can’t remember when I have ever written a prescription for an opioid for anyone who has not had surgery."
As for Daniels, she says physical therapy has helped increase her quality of life.
"Before I could not drive for two hours without pain now I can drive and no pain because of physical therapy," said Daniels.
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The main issue with prescribing opioids for pain is that, naturally, your body already produces beta endorphins, a natural painkiller. With the outside source of opioids, the naturally-produced endorphins are suppressed.
However, several doctors told Boston 25 News that, even when they try to prescribe alternate forms of medicine that are not opioids, they get some pushback from insurance companies.
Dr. Joshua Helm highlights the struggles doctors are faced with when it comes down to getting treatment plans approved by insurance companies.
"Insurance companies and opioid pharmaceutical companies are often working together in various forms," said Helm. "When we work through these cases and try to offer something different we do struggle with getting the medical insurance processing to be on par with what we would see in a pharmaceutical treatment plan."
Doctors say the hardest part is getting through the first hours of pain because there is a delay in finding the cause of the pain. In the interim of that process, there is a temptation for many doctors to prescribe the drugs.
But, many defend that opioids should always be a last resort because they don't take away the pain, they just make you not think about it.
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