Physical Therapy’s Call to Arms

By on December 6, 2017

Combating Chronic Pain

To combat the current opioid epidemic - which has been referred to as the worst drug crisis in American history - the Centers for Disease Control and Prevention (CDC) is urging health care providers to reduce the use of opioids in favor of safer alternatives.1

Although we are a culture that craves a quick fix, prescription painkillers are not always the answer to pain management.  In fact, long-term or high-dosage use of addictive prescription painkillers has led to an average of 91 deaths daily. What’s an alternative solution for pain? Physical therapy.

Bay State College’s Chris Joyce, PT, DPT, SCS advocates the American Physical Therapy Association’s ChoosePT initiative to raise awareness about the risks of opioids for treating pain. Physical therapists and physical therapist assistants are the most well-equipped health providers on musculoskeletal conditions - identifying, diagnosing, and treating movement problems, including pain; however, their expertise is often underutilized. In fact, a study recently found that only 10 percent of patients with low back pain who visited a primary care physician between 1997 and 2010 were referred to a physical therapist.

Dr. Joyce is participating in a large pragmatic national study, the TARGET Trial, aimed at evaluating innovative ways to minimize the transition of acute low back pain becoming chronic. Dr. Joyce and other physical therapists are collaborating with primary care physicians to deliver psychologically informed physical therapy (PIPT) to patients with acute low back pain who are at risk to develop prolonged pain. 

To increase awareness of the trial and the approach of PIPT, Dr. Joyce was asked to present at the annual American Physical Therapy Association of Massachusetts conference. “Physical therapy is embracing and espousing a biopsychosocial model to treating patients in pain. This requires educators, students, and clinicians, to become proficient in fields that haven’t been emphasized in traditional physical therapy education, such as psychology and pain neurophysiology. Integrating this knowledge with our robust background in exercise and movement will be fundamental in the future of our profession.”

Understanding the dynamic interaction of biomedical and biopsychosocial musculoskeletal care is a cornerstone of the Physical Therapist Assistant Program at Bay State College. “We discuss the psychological and social contributors to pain in the classroom but the students really appreciate it when they go out on clinical. They realize that two patients with the same exact injury can necessitate completely different rehabilitation strategies in order to be effective. We want to equip our students with the clinical and interpersonal skills to be able to handle complex patients in pain.”

The work of the TARGET trial and the ChoosePT campaign will continue to become increasingly important as the nation attempts to combat the opioid epidemic. This year, Massachusetts Governor Charlie Baker announced his second significant legislative and administrative actions package to combat the epidemic, including proposals to increase access to treatment and recovery services, strengthen education and prevention, and seek federal regulatory relief. “More and more we’re learning that patients do not need large prescriptions and numerous refills to manage this pain," Baker said. “In fact, they may not need opioids at all.”

For more information on APTA’s MoveForwardPT campaign, visit


1. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Reports. 2016;65(1):1-49. doi:10.15585/mmwr.rr6501e1.