Physical Therapy an Alternative to the High Risks of Methadone

Tallahassee, Florida, August 18, 2008 – A recent investigative report1 published 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.  Physical therapists can play a role in providing patients and physicians with an alternative to dangerous pain medications like oxycodone and methadone.

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.  “Many legitimate patients, following the direction of their doctor, have run into trouble with methadone, including death,” noted pain specialist Dr. Howard A. Heit from Georgetown University.  Florida alone, which keeps detailed data, listed methadone as a cause in 785 deaths in 2007, up from 367 in 2003.

“These are senseless deaths,” said Dr. Timothy Flynn of Regis University in Denver, CO, and President of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT).  “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 spinal manipulation offer strong benefits to spine pain and disability.”  “The medical management of spinal pain in this country is a failure,” continued Flynn, “we too often initiate prescription drug therapy before choosing safe and effective alternatives.”  Flynn suggests that patients seek out physical therapists as a first-line treatment for these conditions.

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% 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 coauthor 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.”

For more on the benefits physical therapists can provide in the management of spinal pain, contact your nearest physical therapist or visit the American Academy of Orthopaedic Manual Physical Therapists website at www.aaompt.org.  AAOMPT represents physical therapists by promoting excellence in orthopaedic manual physical therapy practice, education and research. 

Dr. Richard Deyo, MD, MPH will be the key note speaker at AAOMPT’s Annual Conference in Seattle this November.  The conference theme will focus on pain management and physical therapists’ role in this important area of care.

PHILADELPHIA__The American College of Physicians and the American Pain Society recommend doctors prescribe physical therapy when managing patients with low back pain.

“There are many options for evaluation and treatment of low back pain,” said Amir Qaseem, MD, PhD, MHA, senior medical associate in the American College of Physicians Department of Clinical Programs and Quality of Care, and an author of the guidelines. “We wanted to review all the evidence and develop guidance for clinicians and to give our patients a realistic sense of what they can expect when they visit a clinician for low back pain.  In particular, clinicians should consider the addition of non-pharmacological therapies with proven benefits.”
“This recommendation comes as no surprise to physical therapists,” said Dr. Timothy Flynn from Regis University, Denver, and President of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT). “Research has consistently shown the value of particular physical therapy interventions for patients with low back pain.  Specifically, spinal manipulation and exercise have repeatedly been shown to be effective in managing patients’ current pain and preventing future episodes.  We are glad to see that the American College of Physicians and the American Pain Society recommend physical therapy as a safe and effective alternative to drugs for patients with back pain.”  Physical Therapists can help patients with low back pain by performing thorough examinations and designing an evidence-based treatment program to meet their particular needs.  These treatments can include hands-on therapies to mobilize the spine and exercises designed to alleviate low back pain.
For more on the benefits that physical therapists can provide in the management of low back pain, contact your nearest physical therapist or visit the American Academy of Manual Physical Therapists website at: http://www.aaompt.org.