British Columbia

B.C. physiotherapists say they can help alleviate the opioid crisis

The Physiotherapy Association of British Columbia has released a new position paper which argues physiotherapy has a role in reducing the provincial opioid crisis by reducing reliance on opioids for pain treatment.

Physiotherapy Association of B.C. says physiotherapy can reduce reliance on drugs and potential addiction

Physiotherapy includes a variety of exercise, massage and stimulation techniques that can help those suffering from chronic pain.

In a new position paper, the Physiotherapy Association of British Columbia says physiotherapy should be better utilized to treat chronic pain which would reduce reliance on painkillers and the potential for drug addiction.

The association's CEO, Christine Bradstock, says chronic pain sufferers are often prescribed painkillers as a treatment.

"When they're prescribed painkillers, there has been a tendency for them to take them over a long period of time and increase the opportunity to be addicted to them," she said.

Some research has shown that doctors have over-prescribed prescription opioids for pain management.

The drugs can be highly addicting and difficult to stop using, which, according to health officials, has contributed to the opioid crisis that has killed over 900 people in B.C. alone last year.

Chronic pain specialist Tori Arca says physiotherapy — which includes a variety of exercise, massage and stimulation techniques — can help those suffering from pain.

"Physiotherapy is under-utilized. I think, traditionally, people think of physiotherapists working in a private setting. You know, 'I have a sports injury, or I hurt my knee and I'll go see a physio,'" she said.

"There's so much more to it and there's so much more we can do."

Bradstock said the techniques could ultimately reduce the number of drugs prescribed.

"If we can make use of physiotherapy to help decrease the amount of pain that they're experiencing, then that will help to require less drugs that might be needed to assist the patients."

Physiotherapy already part of treatment

In a statement to CBC News, the College of Physicians and Surgeons says it has "always considered medication to be just one part of the treatment plan for most chronic and non-malignant pain conditions. Physicians are encouraged to suggest non-pharmaceutical options to chronic pain sufferers, especially physical and exercise therapy."

It added that it does not collect data on the amount of non-pharmaceutical therapies used.

Bradstock said her group also does not have data on the use of physiotherapy over drug use.

"Anecdotally, the people who work in the chronic pain clinics and pain management understand clearly that there is less of a requirement to take drugs if you are managing your pain with physiotherapy," she said.

"But there's been no study done to say if you go to a physiotherapist, you will save the province this many millions."

A reasonable position

Nevertheless, Dr. Michael Negraeff, the division head of pain medicine at the University of British Columbia and one of the co-founders of non-profit advocacy group Pain B.C., said it is reasonable to say physiotherapy could play a larger role for chronic pain sufferers and reduce reliance on pharmacological tools like opioids.

"Pain is complex, especially chronic pain," he wrote in an email.

"Many patients go to the doctor, hospital or ER because insurance pays for 100 per cent, but everything else is not paid for ... Patients don't go to [physiotherapy] as they don't want to pay first to find out what it can offer or can't afford to pay at all. Because of years of this, many have no clue what physiotherapy can do for them."

Negraeff said many new physiotherapists are trained in a broad range of therapeutic approaches that can be helpful to patients.

"So yes, physiotherapy can play a big role in chronic pain management."


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