Let’s Talk About Pain : APTA Releases New White Paper on Transforming Pain Management

The American Physical Therapy Association (APTA) released a new white paper in June regarding the Physical Therapist’s role in the management of pain. (Link: https://goo.gl/qGUEkG). The paper was aimed at creating strategies to fight the opioid epidemic and called on policymakers and other stakeholders to push for safer, non-pharmacologic methods to help with pain. I found this paper applicable to the Workers’ Compensation industry; where many time a quick fix (opioids, MRI, surgery) are pushed for over more conservative care and the costs, both financial and physical to the patient, are catastrophic.

The paper covered the history of opioids and how they have become more prevalent along with their impact on the use of more illicit drugs like heroin as well examined the concepts of pain while outlining when opioids may truly be needed versus when a more conservative multidisciplinary approach makes sense. It also covers several scenarios when treatment by a Physical Therapist can help reduce or eliminate the need for the use of opioids.

APTA’s Recommendations in Response to Opioid Crisis

At the end of the paper, the APTA made several recommendations that they deemed part of a comprehensive plan to respond to the opioid crisis. These recommendations included:

• Better public awareness of pain assessment and options for pain management
• Public and private health plans that include “benefit design, reimbursement models, and integrated team approaches that support early access to nonpharmacological interventions, including physical therapy, for the primary care of pain conditions
• Reduction or elimination of patient out-of-pocket costs and increased “access to and payment for person-centered, nonpharmacological pain management and treatment interventions”
• Stepped-up efforts by health plans to educate providers on the effectiveness of nonpharmacological approaches to pain treatment and best practices in assessment, treatment, and referral
• Greater attention by policymakers to what’s working in pain management care, and a willingness to commit to lower patient out-of-pocket costs and innovative approaches, including bundled-care models and the use of multidisciplinary teams
• Federal and state student loan repayment programs that incentivize health care professionals to work in underserved communities, thereby increasing the availability of healthcare providers in areas disproportionately affected by the opioid crisis

It is great to see that the APTA is speaking up about the Physical Therapist’s role in managing pain and the opioid crisis. More attention to policies and health care plan design needs to be given in order to give patients access to safer and more effective care. This includes the Workers’ Compensation system where historically Physical Therapy has been viewed as a cost driver rather than a cost container when all the evidence points to the latter being true.