Prescription painkillers vs. physical therapy
Friday, October 06, 2017
According to a recent survey, 78 percent of Americans prefer to find an alternative form of treatment to deal with physical pain before turning to prescribed medications. That's great news! This data was gathered between February and March 2017 as part of the Gallup-Palmer College of Chiropractic Annual Study of Americans.
Public perception of prescription painkillers
From 1999 to 2015, the number of people dying from opioid overdose in the U.S. has more than quadrupled to 33,000. Opioids include well-known and commonly prescribed painkillers such as codeine, morphine and fentanyl.
This appears to be one of the primary reasons behind the American public's aversion to such medications. An earlier survey by the same team revealed that 44 percent believe prescription painkillers are a "very serious problem" in their area. Interestingly, the numbers who saw cigarettes, alcohol and other recreational drugs as a "very serious problem" was considerably lower.
Several reasons were thought to be behind this problem:
- The pharmaceutical industry encouraging doctors to prescribe medications (55 percent)
- Doctors overprescribing painkillers to their patients (53 percent)
- A lack of public knowledge about the dangers of opioids (49 percent)
- Patients demanding a prescription for opioids (47 percent)
This backs up the fact that both the pharmaceutical and healthcare industries rank among the lowest in the country in terms of image — with only 33 percent of those questioned viewing the pharma industry as very positive or somewhat positive. The healthcare industry came in with 38 percent positivity.
How do Americans choose to treat their pain?
Lower back pain is the most commonly reported form of pain among U.S. adults. In fact, 64 percent of Americans have had back or neck pain at some point in their life. But with this feeling of negativity toward prescription painkillers, what are Americans using to treat their pain?
Nonprescription (over the counter) medications are still popular. For those who have seen a health professional for back or neck pain in the last 12 months, 70 percent were taking NSAIDs such as Advil or Aspirin and 45 percent were using acetaminophen (e.g. Tylenol).
Now, here comes the best news for us physical therapists! Physical therapy was rated as both the safest and the most effective form of treatment for back and neck pain among those surveyed. PT was compared to chiropractic care, prescription medications, self-care and back surgery for effectiveness. OTC medications were also included in the ratings for safety alongside the above treatment options.
68 percent ranked PT as "very safe," and another 28 percent rated it "somewhat safe" — that adds up to 96 percent. For effectiveness, 41 percent rated it "very effective" and another 45 percent rated PT "somewhat effective" — 86 percent total. This demonstrates a real feeling of positivity toward physical therapy as a safe and effective treatment for back and neck pain.
The big contradiction
While the above stats all make for great reading from a PT's point of view, it's not quite as straightforward in reality. The survey then asked the following question:
"Suppose you were experiencing neck or back pain and wanted to see a healthcare provider about it. If you had the opportunity to choose among any of the following healthcare providers and you knew the cost would be the same to you, who would you most like to see about your neck or back pain?"
The first choice for 53 percent of those questioned would still be a medical doctor. So, despite claiming to not want prescribed medications, most would still go to a doctor where a likely course of action would be medication. Second came chiropractor with 28 percent, third was massage therapist with 7 percent, and only 6 percent would choose a physical therapist.
These results do not tally up with answers to the previous questions as chiropractic care was deemed both less safe and less effective than physical therapy, yet more people would choose a chiropractor to treat their back or neck pain.
There were no reasons reported for individuals' choices, so we can only guess at the possibilities for such a U-turn:
- People would prefer a doctor to assess their pain first to make sure they are then referred to the most suitable professional
- People believe a doctor would be more likely to order imaging such as X-rays or MRI scans
- Chiropractic is a more well-known profession than physical therapy
- A lack of full understanding of one or more of the questions
While it appears that the public's perception of physical therapy is positive, we still have a way to go before we're seen as the first choice when it comes to physical, musculoskeletal pain. I believe that this is just a matter of time. Our profession has made monumental steps in the right direction in the last 20 years and given the evidence shown here, I see no reason for the progress to slow.
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