Osteoarthritis currently affects as many as 31 million Americans, making it by far the most common of a group of conditions that are all generally referred to as “arthritis.” Although all types of arthritis affect the joints and lead to a similar set of symptoms, osteoarthritis stands out due to its high incidence and because it’s a progressive condition that gets worse over time.

In a normal joint, a type of tissue called cartilage surrounds and protects the ends of each bone, which prevents them from touching each other and helps to absorb shock from movement and pressure. In osteoarthritis, this layer of cartilage begins to gradually wear away due to a number of possible factors. This means that there is less protection and more friction between the bones in the affected joint, and over time, this process can lead to inflammation and damage of many structures within the joint.

Osteoarthritis can develop in just about any joint, but the vast majority of cases occur in the knees and hips. The reason is that the knees and hips are both weight-bearing joints that must bear the impact of our bodyweight every time we’re on our feet. Taking on too much weight or pressure on these joints can cause the cartilage to wear away faster and accelerate the damage that occurs in osteoarthritis. This is why being overweight or obese is a major risk factor for osteoarthritis in all weight-bearing joints.

The symptoms of hip and knee osteoarthritis are quite similar: pain, swelling, tenderness, and stiffness in the affected joint, as well as a possible “popping,” “cracking,” or “grinding” sensation that comes about with movement. Pain usually tends to get worse during and after activity, and has the added effect of making it difficult to move the joint through its complete range of motion. The end result of these symptoms is being impaired in many activities and movements that involve the legs, such as walking, running, standing up from a chair, and ascending or descending stairs.

Only a physical therapist will focus on finding ways to help you move better

If you experience symptoms of knee or hip osteoarthritis, it’s usually safe to say that you’re next goal is to find some pain relief as fast as possible. There are a number of treatment options available for these types of conditions, from the most mild of simply resting the affected joint, to the most extreme of undergoing surgery to replace the damaged joint. But the best possible choice you can make to manage your osteoarthritis is to see a physical therapist.

Physical therapists are movement experts that are trained to help patients move more easily and efficiently. While there are many interventions out there that claim to relieve pain and improve function, only physical therapy will provide you with a comprehensive treatment plan that involves a variety of movement-based strategies to address your deficits and strengthen any areas of weakness. Physical therapy focuses on finding active ways to help you overcome your symptoms, and it trains patients to continue these healthy habits in the long term.

Each physical therapy program will differ depending on the severity of the osteoarthritis, and the age and abilities of the patient, but most interventions used fall into one of the following three categories:

• Pain-relieving modalities: your therapist may use ice, heat, ultrasound, machines that emit electrical currents (TENS), or other similar treatments to reduce your pain levels on the spot
• Exercise therapy: exercise is central to all physical therapy programs and is crucial for helping you overcome your impairments and be able to better move your affected joint; the two primary types of exercise therapy are:
• Stretching exercises: since flexibility is usually reduced in the hip or knee affected by osteoarthritis, these exercises will help to improve your ability to bend and straighten your knee or rotate your hip with movements you can tolerate
• Strengthening exercises: lack of movement due to pain can result in muscle weakness and even less ability to complete tasks normally; building the muscles back up around the hip or knee has been associated with less pain and better function, and will therefore be a major focus on most treatment plans
• Manual therapy: this is a hands-on treatment in which the physical therapist will gently move muscles and joints to improve their motion, flexibility, and strength, and will usually target areas that are difficult to treat on your own

There is a great deal of research that has shown both exercise therapy and manual therapy to be effective treatments for patients with hip or knee osteoarthritis. In one study published in 2016, it was found that “An exercise therapy intervention provides short-term as well as long-term benefits in terms of reduction in pain, and improvement in physical function among people with hip osteoarthritis.” Another study published in July of 2018 highlighted how greater participation levels in physical therapy lead to better outcomes for patients with knee osteoarthritis, with a conclusion that stated:
Increased number of physical therapy visits was associated with improved outcomes, and some of this benefit persisted eight months after physical therapy ended.

Finally, a study published last September showed how even better outcomes can be achieved when both exercise therapy and manual therapy are combined. In this high-quality analysis, researchers reviewed a number of studies on the topic and found that:

Orthopedic manual therapy interventions with exercise therapy compared with exercise therapy alone provide short term benefits in reducing pain, improving function, and stairs ascending-descending time in people with knee osteoarthritis.

The term “arthritis” is used to describe more than 100 different conditions, all of which are defined by inflammation of one or more joints and a resulting set of bothersome symptoms. The exact cause in each case depends on what type of arthritis is present, but the common thread between them is a firm but flexible material tissue called cartilage. Cartilage normally surrounds the ends of bones in each joint to protect them and absorb shock, but problems can arise when it’s altered in any way.

In osteoarthritis, the most common type of arthritis, this protective cartilage gradually wears away over time due to age-related changes and several other factors. In rheumatoid arthritis, the cartilage erodes because the body’s immune system mistakenly identifies it as foreign and begins to attack it. Similar processes occur in all other types of arthritis as well, but the end result is always the same: after enough cartilage has worn away, the affected joint will no longer function normally.

Between pain, stiffness, and this reduced range of motion, most patients with arthritis begin to notice impairments in their daily lives and find that many otherwise simple tasks have become a challenge. Arthritis symptoms and the resulting amount of disability will of course vary depending its type and severity, but all patients will experience some difficulties functioning at one point or another. This brings up another similarity between all individuals with arthritis: a desire to make the pain go away.

How to alleviate arthritis symptoms on your own

Unfortunately, there is no cure for arthritis that will make cartilage grow back or completely stop the loss of it from occurring, but there are actually a number of steps you can take to reduce or eliminate your symptoms right now. Below are some of the best home remedies available. Consider discussing these options with your healthcare provider if you’re unfamiliar or have any questions:

• Bracing: wearing a brace is associated with a number of potential benefits for individuals with arthritis, such as enhanced stability, reduced swelling and pressure on the joint, and increased confidence when walking; braces help to shift bodyweight away from the damaged area of the affected joint, which alleviates pain and discomfort in the process; braces come in a variety of shapes, sizes, and styles, and are most commonly used for patients whose knees or ankles are affected by arthritis; talk to your doctor if you’re interested in wearing a brace for your arthritis
• Exercise: staying physically active is one of the best possible ways to treat arthritis symptoms, as it builds strength and improves the flexibility of joints; all forms of exercise can be helpful, but aquatic exercise is particularly recommended because it’s low impact and therefore does not put any added pressure on painful joints
• Hot and cold therapy: another simple home remedy is applying ice or heat to the affected joint when symptoms arise; cold therapy can reduce inflammation, swelling and pain, while heat can relax muscles and help lubricate joints, which can also relieve muscle and joint stiffness in the process; it’s often best to start with ice and then alternate with heat to maximize benefits
• Mobility devices: if your arthritis is severe enough, a device like a cane, walker, or wheelchair may be necessary to improve your mobility and allow you to get around on your own more easily; although this may be a difficult adjustment, it’s important to follow your doctor or physical therapist’s instructions and learn how to properly use your device in order to stay mobile
• Anti-inflammatory medications: some arthritis patients experience immediate joint pain relief from over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and aspirin; talk to your doctor if you’re not sure if these drugs are right for you or how much/how frequently to take them
• Diet: lots of research has shown that what you eat can have a significant impact on the amount of inflammation present in your joints, and that eating anti-inflammatory foods can actually reduce inflammation and swelling responsible for arthritis symptoms; for example, the Mediterranean diet, which emphasizes lots of vegetables, whole grains, fish, and healthy fats, has been associated with lower levels of inflammation and may therefore be worth considering
• Physical therapy: if it feels like you’ve tried everything for your arthritis symptoms—including all the tips on this list—and your symptoms still haven’t gotten any better, it may be time to see a physical therapist for a comprehensive treatment program; ask your doctor for a referral or simply make an appointment on your own, since all states allow for some direct access to physical therapy

Few conditions are as well known to the general public as arthritis, which is probably because about 54 million Americans—or about 23% of the population—are currently affected by it. These figures could naturally be a bit alarming and lead some to wonder what their personal risk is for developing arthritis and if there’s anything they can do to reduce it.

The truth is that there are many different types of arthritis and a multitude of factors that play into each individual’s chances of getting it. While some of these factors are completely out of one’s control and cannot be altered, others are considered “modifiable,” and making changes to them may have a significant impact on your personal risk for arthritis.

Osteoarthritis is by far the most common of the more than 100 different types of arthritis. As many as 31 million individuals currently have osteoarthritis, and the majority of cases are seen in those who are over the age of 65. Osteoarthritis is also the most preventable of all forms of arthritis, whereas for many other types—like rheumatoid arthritis, for example—not as much can be done to prevent them from occurring because their causes are not well understood.

Focusing on the risk factors that you can control

Osteoarthritis is a complex process that results from a number of different causes. Older age does play a part because the body naturally undergoes several changes that make joints more vulnerable to developing it. Therefore, since nothing can be done to stop the aging process, older age is considered a “non-modifiable” risk factor for osteoarthritis. Other non-modifiable risk factors are being female (since females are at an increased risk for all forms of arthritis) and family history (since some people are more likely to get it because of their genetic background.)

But these are just a few of the factors that determine a person’s risk, and there are many others that are actually modifiable. Below is a breakdown of the risk factors for osteoarthritis that you do have control over and some associated suggestions on how you can modify them in order to keep your personal risk as low as possible:

Maintain a healthy weight

• Excess weight is one of the biggest risk factors for osteoarthritis, and it also happens to be one that you have the power to change
• Here’s why: when you are overweight, the extra pounds put added pressure on weight-bearing joints like the knees and hips; each additional pound of bodyweight adds nearly four pounds of stress to the knees and increases pressure on the hips by nearly six fold, and over time, this extra strain breaks down cartilage in joints and increases the risk for osteoarthritis
• For individuals who are overweight, losing at least 5% of their bodyweight may decrease the amount of stress on the hips, knees, and lower back; one study actually found that overweight women who lost 11 pounds decreased their risk for osteoarthritis by more than 50%
• Tips: losing weight is no easy task, and there are many components that go into it, but your primary focus should be on eating right, making necessary lifestyle changes, and exercising more, which actually happens to be another major modifiable risk factor

More physical activity

• Weight and activity levels go hand-in-hand as the two osteoarthritis risk factors that can be appropriately addressed to manage your risk
• Exercising and becoming more physically active will not only help you achieve and maintain a healthy weight, but serves a number of other important purposes as well: it keeps your joints moving and prevents stiffness, strengthens the muscles around joints, and improves your mobility, all of which play a part in reducing the risk for osteoarthritis
• Inactivity, on the other hand, can actually make joints more likely to be affected by osteoarthritis
• Tips: aim to get the recommended 150 minutes of moderate-intensity activity (like brisk walking) or 75 minutes of a vigorous-intensity activity (like jogging) AND two days of strength training each week; it’s important to point out that physical activity includes anything that keeps you moving, so shoveling snow, taking the stairs at work, and mopping the floor all count towards your totals

Other

• Avoid injury: injuring weight-bearing joints like the knees or hips can make cartilage wear out quicker, so it’s best to take steps to lower your risk whenever possible, such as:
  • Participate in a sport-specific injury prevention program
  • Take adequate time to rest and recover
  • Avoid overtraining and pushing your body too hard
• Get injuries treated: if you do notice any pain or soreness developing in any of the joints that osteoarthritis normally occurs in, get it looked at right away by a physical therapist or your doctor
• Control your blood sugar: studies have shown that diabetes may be a significant risk factor for osteoarthritis, as high glucose levels may speed up the formation of molecules that make cartilage stiffer and more sensitive to stress; so if you’re diabetic or prediabetic, it’s extra important to watch your glucose levels and keep them within a healthy range to reduce your risk for osteoarthritis

Arthritis is one of the most commonly recognized conditions responsible for pain, and there’s a clear reason why: it happens to be one of the leading causes of disability throughout the world. Many people also tend to associate arthritis with older age, which can lead to the perception that it’s only something to worry about “when that time comes.” While it is true that the risk for certain types of arthritis do increase with age, there are actually many different forms, and it’s important to understand that you can be affected by it at any stage of life.

The first point that needs to be made about arthritis is that it’s not a single disease. Instead, the term “arthritis” is used describe over 100 conditions that affect the joints or tissues around the joints. While there are unique characteristics of each type of arthritis that require special attention, they all involve inflammation of one or more joints in the body, and generally result in pain and stiffness in and around the affected joint(s).

Right now, approximately 54 million Americans—which is about 23% of the population—have some type of arthritis. For some individuals, arthritis symptoms may be barely detectable or come and go, while others are severely impaired by their condition on a daily basis. The amount of disability that arthritis causes will typically depend on its specific type, intensity, and possibly the person’s age.

Most common type of arthritis—osteoarthritis—is more likely to occur in older adults

Osteoarthritis is far and away the most common type of arthritis. While figures vary, it’s estimated that as many as 31 million individuals are currently affected by osteoarthritis in the U.S. This type of arthritis is also typically associated with older age, and in this case, the connection is somewhat accurate.

In every joint in the body, two bones meet in order to allow movement. The ends of each of these bones are normally covered by cartilage, which protects the bones from rubbing against one another and serves as a shock absorber for impact upon the joint. Osteoarthritis causes the cartilage in certain joints to become stiff and lose its elasticity, which makes it more vulnerable to damage. Over time, the cartilage may begin to wear away, which greatly reduces its ability to absorb shock and increases the chances of the bones coming in contact with one another.

Osteoarthritis can occur at any age, but the chances of getting it increase significantly as the body grows older. The majority of people with osteoarthritis are at least 40, and some studies have shown that about 70% of individuals over the age of 70 have at least some signs of it, whether they notice symptoms or not. The main reason for this is that the aging process leads to certain changes in the body that cannot be reversed. Bones become less dense and more fragile, and the there is less water in the cartilage as it also begins to shrink in size. The result of these changes is less protection of the bones, which often results in inflammation and symptoms like pain and stiffness.

Rheumatoid arthritis and juvenile arthritis are more common at other ages

Another fairly common type of arthritis is called rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease, which means it’s caused by the body’s immune system mistakenly destroying healthy tissue in the lining of joints for unknown reasons. This attack causes the joints to become inflamed, swollen, and painful, but other areas of the body may also be affected, and symptoms like fatigue, fever, and loss of appetite may occur. About 1.5 million Americans have rheumatoid arthritis, and three times as many women are affected by it as men.

Rheumatoid arthritis also tends to be associated with older age, but unlike osteoarthritis, it does not occur due to age-related changes and is usually seen earlier in life. The average age for onset of rheumatoid arthritis is between 30-60, but it’s also seen in younger individuals as well. Regardless of age, rheumatoid arthritis is a chronic disease that gets progressively worse over time. Symptoms vary from person to person, but in most cases it causes periods of increased symptoms (flares) followed by periods of symptom-free remission.

The chances of developing arthritis are even lower in childhood, but there is still a risk that must be acknowledged. The most common type of arthritis in those under the age of 17 is juvenile arthritis, which affects about 300,000 individuals.

The term juvenile arthritis includes many different inflammatory and autoimmune disorders that, like rheumatoid arthritis, cause the immune system to attack its own healthy cells in joints. It’s not clearly understood why this occurs, but both genetic and environmental factors likely play a part. Whatever its cause, juvenile arthritis also leads to a similar set of symptoms, such as pain, swelling, and stiffness that can interfere with a child’s daily functioning. So as with all forms of arthritis, these children require a set of tools and treatments to alleviate their symptoms and allow them to carry on with their lives in less pain.

Try as we might, it’s nearly impossible to avoid all pain in our lives. Whether it’s twisted ankle or a bad back, we all experience some pain at one point or another, which is why the presence of pain is by far the most common reason people seek out health care. But treating pain, especially chronic pain lasting for more than three months, is not always an easy or straightforward matter. Treatment often requires a multifaceted approach that includes a number of different components due to the many variables that contribute to a patient’s perception of pain and their response to treatment.

Opioids are natural and synthetic drugs that are commonly prescribed for pain. Some patients, such as those with cancer or other serious illnesses, and those who are on end-of-life care, may require opioids due to the extreme amount of pain they are in. Opioids may also be appropriate for a limited period of time for certain short-lived (acute) painful conditions; however, it’s not clear if they are also effective for patients with chronic pain. But this has not stopped medical professionals from prescribing these drugs to address all types of conditions.

Since the late ‘80s and early ‘90s, opioids have been prescribed on a grand scale to individuals dealing with both acute and chronic pain. Over the years, prescribing these drugs has become a standard practice that many doctors assumed was safe and effective, even though there has always been a lack of high-quality research on the benefits and harms of opioids. As a result, opioids have been overprescribed for far too long, as at least 400,000 people have died of an opioid overdose between 1999-2017.

The epidemic has brought light to the situation and raised questions about prescribing these drugs to patients dealing with pain, and professional organizations like the CDC have provided guidelines as to when and how to give prescription, and what to do to address this problem. One of the central messages that has been stressed by healthcare leaders in various positions is that physical therapy should be utilized as a first-line treatment and an alternative to opioids for managing pain. Here are some examples:

• In August of 2016, the U.S. Surgeon General at the time, Vivek Murthy, MD sent a letter to 2.3 million medical professionals to address the opioid epidemic provide a call to action to end it. The letter was combined with an infographic to assist these professionals in the prescription of opioids, and one of the central recommendations made was to consider non-opioid therapies first, with physical therapy being listed as an important alternative.
• The current U.S. Surgeon General Jerome Adams, MD spoke at an event hosted by the American Physical Therapy Association (APTA) this past January, during which he focused on the opioid crisis and the role of physical therapy in addressing it. He highlighted the essential role that physical therapists can play by offering pain-relieving services to patients, and stressed the importance of educating these individuals on a national scale.
• A task force made up of experts in various medical fields was created in 2018 in order to establish guidelines for managing pain and the role of opioids in the process. One of the key guidelines was that restorative therapies like physical therapy should be a central component of patient care. It points out that these therapies play a significant role in managing acute and chronic pain, and that positive patient outcomes are more likely when they are used.

There are many reasons why physical therapy has become recognized as such an effective alternative to opioids. Narcotics like opioids are only meant to decrease someone’s perception or sensation of pain, and they are not intended to actually address the issues that are causing it. This is why opioids are only supposed to be used temporarily until the pain subsides. Physical therapy, on the other hand, is not a temporary solution. Instead, it focuses on identifying the origin of the pain, and then creates a personalized treatment program designed to alleviate it permanently.

The benefits of physical therapy and its power to help patients avoid opioids have also been highlighted in a number of recent research studies. One study investigated whether seeing a physical therapist early for low back pain had an impact on the amount of healthcare each patient used and if they received an opioid prescription. The results showed that early physical therapy reduced healthcare utilization and costs, and also lowered the rates of opioid use, which may improve the efficiency of healthcare.


But despite the many signs that physical therapy is a much smarter and safer solution to pain than opioids, there is still a ways to go in changing how doctors manage patients in pain. In another study that reviewed data on patients with low back pain over 14 years, it was found that doctors only referred about 10% of patients to physical therapy, and this rate remained low through the entire period of time. The number of doctor visits that led to an opioid prescription, however, increased during this time in this same population.

This shows that while it’s important for medical professionals to do their part by prescribing opioids only when they are absolutely necessary and for short periods of time, patients must realize that they also have a choice in this matter. Seeing a physical therapist first will help you get on the path to an active and self-directed approach to pain, which focuses on patient participation to yield the best possible results. This approach to care also comes without the side effects and serious risks associated with an opioid prescription, meaning patients can be more confident that their treatment will help them improve while avoiding the dangers of these medications.

When most people hear about physical therapy, they usually tend to think that it’s only for disabled individuals and those who are recovering from injury. While it may be true that physical therapy is perhaps most commonly used on patients that fall into these two categories, this is far from its only application. Physical therapists can also help individuals reduce their risk for injury by identifying any imbalances that might be present and addressing them with a targeted exercise program.

Physical therapists are rehabilitation specialists and experts at evaluating how each patient moves their body when performing normal daily tasks. They then use this information to determine if the individual has any issues with their posture, strength, motion, or balance (which is usually the case, since very few people move “perfectly.”)

What many people don’t realize is that these issues generally exist prior to the onset of pain and increase the chances of an injury occurring. It’s for this reason that a great deal of pain related to bones and muscles, as well as many injuries, can actually be prevented. But injury prevention requires identifying potential problems and strategically addressing them, and physical therapists are the most qualified medical professionals to provide this service.

Whether you get lots of physical activity or not, you’ve probably dealt with your share of pain in one form or another. Painful conditions like low back pain, neck pain, and ankle soreness are extremely common across the board in both active and sedentary individuals, and it’s often difficult to pinpoint exactly what the source of pain is. While most of these episodes will improve over time on their own, that doesn’t necessarily mean that the pain won’t return or is nothing to be concerned with. In some cases, these apparently minor bouts of pain may actually be warning signs for a bigger problem with more pain or an injury down the road. It’s often challenging to know the difference, but this is exactly what physical therapists specialize in.

A physical therapy program can prevent injuries and other medical conditions in a number of different ways, but in all cases the approach is the same: help patients to move better and more frequently so that their bodies become more efficient and balanced. Below are some highlights of how physical therapy is used to prevent injuries and when it may be appropriate:

• Education: after performing a thorough evaluation of your body and movements, your physical therapist will identify areas that are weak, out of balance, or inflexible; from here, the therapist will educate you by explaining these deficits and what can be done to address them in order to reduce your injury risk
• Sport-specific injury prevention: for athletes involved in a single sport, your physical therapist can provide you with a training program that takes into account the movements involved and common injuries in order to reduce your risk
• Lifestyle modifications and exercise recommendations: if you’re not exercising regularly or lead a sedentary lifestyle that involves lots of sitting, your physical therapist will recommend that you become more active in general and also offer specific ways to do so in your daily life; leading a physically active lifestyle is considered one of the best ways to reduce the risk for a host of health conditions like arthritis, diabetes, heart disease, and some types of cancer
• Prehabilitation: surgery may be needed for patients with severe injuries, but the procedure is not the end of the story; a rehabilitation program before surgery—called prehabilitation—will help you prepare the body for what’s to come and drastically increase the chances of a successful recovery with a lower risk for injury in the future

This shows that physical therapy is not only for injuries that have already occurred, but also for stopping those from occurring in the first place. This can easily be achieved by seeing a physical therapist for a full-scale evaluation and then following their recommendations afterwards. Perhaps the best part is that you don’t need a referral from another doctor to see a physical therapist. All 50 states and Washington, D.C. allow for direct access, which means you can schedule a physical therapy appointment on your own whenever you’re ready.

Have you dealt with any pain recently—or perhaps right now—that prevents you from moving or completing certain tasks normally? If so, it’s probably due to some type of musculoskeletal disorder. This term is used to describe a wide array of conditions that are frequently responsible for causing all sorts of disabilities, but there is one common thread between all of them: they can be effectively treated by physical therapy.

A musculoskeletal disorder is an injury or condition that involves the musculoskeletal system—which includes the bones, muscles, joints, ligaments and tendons. These disorders are extremely common, as about 30% of Americans are currently dealing with one at any point in time.

Musculoskeletal disorders can develop anywhere in the body, but there are certain conditions that occur much more frequently than others. Back pain, especially low back pain, is by far the most common of all musculoskeletal disorders. It is the leading cause of disability in the U.S. for those under the age of 45, and more than 26 million Americans between 20-64 experience frequent back pain. Severe headaches and neck pain rank just behind back pain and often lead to bothersome symptoms that interfere with daily life. Other common musculoskeletal disorders include osteoarthritis, tendinitis, and stress fractures, as well as a variety of issues related to other parts of the body. Below is a sample of some of these conditions in commonly injured joints:

• Knee: runner’s knee, jumper’s knee, iliotibial band syndrome
• Shoulder: frozen shoulder, rotator cuff tears, shoulder impingement
• Wrist: sprains, carpal tunnel syndrome
• Ankle/foot: ankle sprain, Achilles tendinitis, plantar fasciitis
• Elbow: tennis elbow, golfer’s elbow

Individuals dealing with a musculoskeletal disorder have many options when it comes to deciding how to address it. Some will do nothing and hope that pain will go away on its own, while others may see their doctor, who might prescribe medications like opioids, additional tests, or in severe cases, surgery. Another option is physical therapy, which gets to the root of the problem and addresses it with a series of carefully designed exercises and treatments that are individually tailored to each patient. Treatment therefore varies from one patient to the next, but typically consists of the following:

• Evaluation: required to determine the source of the pain and to identify which of musculoskeletal disorder is present
• Strengthening exercises: essential for areas that have become weak
• Stretching exercises: targets regions that have lost flexibility
• Manual therapy: mobilizations and manipulations to the soft tissue of injured areas to reduce pain and improve function
• Posture training: may be needed if posture is a factor
• Lifestyle modifications: habits and other lifestyle choices that may be contributing to the injury are identified and suggestions are provided on how to modify them

So if a musculoskeletal disorder is holding you back from enjoying your life, it’s important to realize that you have a number of options, but physical therapy will nearly always be your best path forward to less pain and better functioning.

The presence of pain—especially pain that lasts for a long period of time—is perhaps the most common reason that people seek out medical help. Because pain is such a unique and subjective experience, it’s also one of the most controversial and complex medical conditions to treat. There are a seemingly endless number of options available to treat pain, but none receive nearly as much attention these days as opioids, and there are a great many reasons why this is the case.

Opioids are powerful pain-relieving medications that have been used to treat pain as far back as 1775, but it wasn’t until the late ‘80s and early ‘90s that “the opioid epidemic” really started to pick up. Around this time, it was believed that opioids could be used safely and effectively to treat chronic (long-lasting) pain, and a push was made to more aggressively manage painful conditions with these drugs. This misguided belief led to opioids being overprescribed on a massive scale, and a number of other factors have contributed to widespread overuse, addiction, and overdoses throughout the country.

Every day, about 130 Americans die from an opioid-related overdose. In 2017, there were over 70,000 drug overdose deaths, with approximately 68% of these involving opioids. And the startling statistics don’t end there. To put matters in better perspective, here are some additional figures on opioid prescription and abuse in the U.S.:

• Although the U.S. represents less than 5% of the world’s population, we consume more than 80% of the global supply of opioids
• In 2016, healthcare providers wrote more than 214 million prescriptions for opioids to manage pain, which equates to about 66.5 prescriptions for every 100 Americans
• As many as 1 in 5 people receive an opioid prescription for non-cancer pain
• The number of opioid prescriptions increased by 600% from 1997-2007
• Between 1999-2017, there were more than 700,000 drug overdose deaths, with about 400,000 of these being related to opioids
• In 2017, the number of overdose deaths involving opioids was six times higher than it was in 1999

So as you can see, far too many individuals are prescribed opioids for their pain every year, and a great deal of them—over 11 million in 2016—go on to abuse these drugs. While opioids do serve an important and necessary role in managing some types of pain, one of the primary issues is that they are frequently being prescribed for many patients with conditions that would benefit more from other interventions. This is because opioids are only meant to decrease each individual’s perception or sensation of pain, and they are not intended to actually address the factor responsible for the pain. In this way, opioids only “mask” the pain and don’t do anything to alleviate it, which is why they are only supposed to be used temporarily until the pain subsides.

Pain is an extremely tricky problem to treat. There is no single solution that will eliminate pain in all individuals, and what works for some won’t work for others. Opioids are often prescribed to solve a complicated issue with a simple fix, but as the numbers very clearly show, the risks associated with these drugs far outweigh the potential benefits. As a result, opioids should be avoided in most cases in favor of one of the many—safer—alternatives available to managing pain.

What you consume can play a major role in your recovery process

When you visit a physical therapist for an injury, you typically expect to be provided with a program that includes various exercises, techniques and other treatments intended to reduce your pain and improve your physical abilities. What you may not expect is advice on nutrition and your diet, since physical therapy seems to be more focused on how the body moves. Focusing on patients’ physical condition is certainly a big part of physical therapy, and it’s for this very reason that some physical therapists are starting to offer nutritional education on top of their regular treatment as a useful tool to improve patients’ overall health outcomes. Since what you put into your body will affect how it works and how well it moves, these therapists are realizing that proper nutrition should be considered an essential component of any treatment program.

Five conditions associated with pain that better nutrition can help address

Learning about nutrition and making changes your diet can result in a bounty of benefits that will improve your health in a number of ways. But there are several conditions associated with pain that can directly benefit from a better diet, including these five:

1. Inflammation: many foods that are popular in the Western diet—like vegetable oils and fried foods—increase inflammation and can often make injuries worse; a Mediterranean diet, on the other hand, which is rich in healthy fatty acids, fruits, vegetables, and fiber, fights inflammation and can be beneficial for individuals with rheumatoid arthritis and other inflammatory conditions
2. Obesity: being obese contributes to many other chronic pain conditions, and the pain can, in turn, lead to less physical activity and make the problem worse; this is why weight loss through proper nutritional health should become a crucial part of overall pain rehabilitation
3. Osteoarthritis: patients who are overweight or obese have an increased risk for developing osteoarthritis, especially in the knees and hips; it’s also been suggested that deficiencies of certain nutrients—including vitamins C and D, and selenium—contribute to osteoarthritis; this shows that focusing on nutrition may address osteoarthritis in several ways
4. Autoimmune disease: approximately 23.5 million Americans have an autoimmune disease, and new research is suggesting that dietary changes over the past 50 years may have played a part in increasing rates of these diseases. Moving away from a high-sugar, high-salt and heavily processed diet to a more nutritious one may, therefore, reduce the occurrence of autoimmune disease.
5. Prediabetes and type 2 diabetes: High pain levels in patients with type 2 diabetes can negatively impact their quality of life, physical function, and physical activity abilities. Diet is an integral part of managing diabetes, and improving it can yield a host of benefits.

How your physical therapist may be able to help

If you’re dealing with any of the conditions listed above along with an injury, your physical therapist may be able to offer some professional advice and education on the role your diet may be playing. By asking you about some of your dietary habits, suggesting that you keep a food diary, and establishing some simple and attainable goals, they can start you on a path to better nutrition and better overall health, which will, in turn, result in a faster recovery from your injury. Following a course that focuses on proper nutrition will also set you up for a better functioning body and a reduced risk for injury in the future.

-Summarized from a Nov. ’16 article published by theAPTA

Many treatments available for extremely common condition

Approximately 80% of the population will experience low back pain (LBP) at some point in their lifetime, and it’s one of the most common reasons that leads patients to visit a medical professional for treatment. There are many treatments available for addressing acute LBP, which is pain that has lasted for less than six weeks, including pain medications, muscle relaxants, exercises and physical therapy. One intervention that physical therapists may utilize for LBP is called spinal manipulation, in which they manipulate certain parts of the spine with their hands in order to bring about changes that will reduce patients’ pain levels. Although some studies have found spinal manipulation to be beneficial for patients with LBP, others have found mixed results and called into question its actual effectiveness. For this reason, a powerful pairing of studies called a systematic review and meta-analysis was conducted to determine the true value of spinal manipulation for LBP.

26 studies are included in the comprehensive review

To conduct the study, investigators searched through four major medical databases for studies that evaluated spinal manipulation for LBP. They identified 40 articles and then screened them for inclusion, and from these, 26 randomized-controlled trials (RCTs) were accepted for the review. RCTs are high-quality studies in which groups of patients are randomly assigned to different treatment groups, and they are considered the gold standard for evaluating if an intervention is effective. Once accepted, all 26 RCTs were analyzed and their findings were compared to one another. In the final step, each study was assessed for its level of quality in order to help determine how reliable its findings were.

Spinal manipulation leads to significant benefits for six weeks

Results showed that spinal manipulation led to significant benefits for patients with acute LBP that lasted for at least six weeks. In particular, the treatment was found to be associated with reduced pain and improved function, and these improvements were graded as modest. In addition, spinal manipulation was only associated with very minor and temporary harms afterward. Twelve of the included studies were classified as high quality, while the other 14 were graded as low quality. This review adds to the literature that already exists on the topic, and should further strengthen recommendations to use spinal manipulation for patients dealing with acute LBP. Based on these findings, taking this type of approach will bring about several benefits in the short term. For this reason, additional studies are also needed to evaluate the long-term effects of spinal manipulation for patients with acute LBP.

-As reported in the April ’17 issue of JAMA