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Why You Should Choose Movement Over Medication
Were you prescribed opioids and are unsure whether or not you want to take them? While it is completely your choice and perfectly acceptable to take pain medications after a surgery for temporary relief, understanding how they work, the potential side effects and risks, and what alternatives are available is really important for making informed decisions and choosing the best course of action for you.
What is considered an opioid?
Opioids get their name because they are a version of opiates, which are drugs that come from the opium poppy plant. Opioids specifically (which are man-made) and other types of opiates work via the same mechanisms, and are seldom differentiated. These drugs are considered narcotics and are prescribed and taken in an effort to block the sensation of pain. Other forms of opioids may be used as a cough-suppressant or anti-diarrheal due to their mechanism of action on related body systems. Some examples of opioids include codeine, fentanyl, hydrocodone, morphine, and oxycodone. Tramadol is another commonly prescribed medication that is a type of opioid considered to be less habit-forming.
The effects of opioids on your body
Cells within our body have receptors designed to bind to specific counterparts - the way a puzzle piece fits into a puzzle - depending on the nature and function of that receptor. Opioid receptors can be found throughout the body, particularly concentrated in the nervous system. Opioids work to decrease pain by binding to these receptors and blocking pain signals from being sent to the brain, thus reducing or prohibiting the sensation and experience of pain. It is important to note that opioids do not eliminate the source of the pain, but rather mask the pain temporarily.
Additionally, opioids can also impact other body systems and structures that control additional functions besides pain mediation such as:
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While sometimes opioids produce desirable effects, they may cause several unwanted side effects. It is important to understand why you are taking them and the implications for your own health.
Opioids can affect mood changes and encourage dependency
As mentioned in the chart above, opioids can disrupt mood regulation and subsequently result in social withdrawal. Additionally, they can easily become habit forming. Opioids may cause a reduction or alteration of consciousness and facilitate a state of euphoria – which is why they are often abused. Prolonged use of opioids can also result in developing a tolerance to the drug, requiring more of it to achieve the same desired effects. Likewise, the body may stop naturally producing what are called endogenous opioids that are very important in responding to stress, regulating pain, motivation, and emotion. This becomes a dangerous cycle that in some cases leads to dependency and addiction if not addressed.
According to the NIDA, in 2017 1.7 million people in the United States suffered from substance disorders specifically related to prescription opioids. For further emphasis, it is estimated that between 8 and 12 percent of people using an opioid prescribed to them for chronic pain will develop an opioid use disorder – it can happen to anyone and it is truly a cause for caution whenever taking this type of pain medication.
Why physical therapy wins!
Physical activity and exercise have been shown time and time again to have a positive impact on pain management with lasting results because it addresses the root of the problem as opposed to simply removing pain temporarily. Studies have shown that those who participate in PT actually stop taking opioid prescriptions after surgery sooner and have better functional outcomes than those who do not. Exercise boosts your mood, improves your cardiovascular and muscular health, and even enhances your body’s ability to heal itself.
Whether you are post-op or dealing with chronic pain, physical therapy provides you with the tools to treat the underlying impairment and better manage the cause of pain. Physical therapists are not only able to create a plan of care based on exercise to strengthen the body and improve overall health, but they are equipped with the knowledge and training to provide important pain education and empower patients to use their new found knowledge as part of their recovery.
Have an upcoming surgery? Dealing with post-op or chronic pain? It’s never too early or too late to get in touch with a physical therapist to help you navigate alternatives to opioids for pain management. Download the OneStep Digital Physical Therapy app to be automatically connected with a licensed PT and have access to our 24/7 chat where you can ask any and all pain related questions.
References:
Pathan H, Williams J. Basic opioid pharmacology: an update. Br J Pain. 2012;6(1):11-16. doi:10.1177/2049463712438493
Opioid Overdose Crisis. National Institute on Drug Abuse. Published March 11, 2021. Accessed February 2, 2022. https://nida.nih.gov/drug-topics/opioids/opioid-overdose-crisis
Pritchard KT, Baillargeon J, Raji M, Chou LN, Downer B, Kuo YF. Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of medicare enrollees. ACRM. 2021;102:1257-66. https://doi.org/10.1016/j.apmr.2021.01.086
Sun E, Moshfegh J, Rishel CA, Cook CE, Goode AP, George SZ. Association of Early Physical Therapy With Long-term Opioid Use Among Opioid-Naive Patients With Musculoskeletal Pain. JAMA Netw Open. 2018;1(8):e185909. doi:10.1001/jamanetworkopen.2018.5909
Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;1(1):CD011279. doi:10.1002/14651858.CD011279.pub2
Dhaliwal A, Gupta M. Physiology, Opioid Receptor. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing: updated July 26, 2021. Accessed February 2, 2022. https://www.ncbi.nlm.nih.gov/books/NBK546642/
