Pain Is Always a Perception’: Physical Therapy Can Help Prevent, Treat Opioid Use Disorder

AHA Publisher — Mon, 12 Apr 2021 07:00:31 +0000

West Virginia University via EurekAlert – When you think of ways to treat opioid use disorder, you might think methadone clinics and Narcotics Anonymous meetings. You probably don’t imagine stretches and strengthening exercises. But Anne Swisher–professor at the West Virginia University School of Medicine–is working to address opioid misuse in an unconventional way: through physical therapy. She and her colleagues have enhanced physical therapy instruction at WVU to emphasize the profession’s role in preventing and treating opioid use disorder. “Students have different interests and passions within the profession, and they find their niche,” said Swisher, a researcher and director of scholarship in the Division of Physical Therapy. “No matter what their passion is, there is a way they can make a difference, whether it’s by preventing people from starting down the road of opioids–by minimizing pain medication and doing movement interventions–or whether it’s by helping people in the recovery process become healthier overall.” Swisher and her team devised a model to show doctor of physical therapy students how key topics in their curriculum–such as women’s health, pediatric care and sports therapy–could all address opioid use disorder in various ways. Their model–which was published in prestigious rehabilitation journal Physical Therapy–is innovative because it goes beyond musculoskeletal issues and addresses how physical therapists can assist people across the lifespan, from neonatal to hospice settings. It also illustrates how physical therapists can help improve human movement across what Swisher calls the “whole addiction spectrum.” “In our curriculum, our students learn about all of these different aspects–what to do with somebody who’s critically ill, the appropriate developmental milestones for children, how to help older people stay active–but it was really just a matter of connecting it all together,” she said. For instance, by making it easier for pregnant women to manage their aches and pains without opioids, physical therapists can help prevent neonatal abstinence syndrome in newborns. By combining special exercises with pharmacological treatment, they can reduce opioid use in patients after spinal surgery. And by promoting healthy physical activity in general, they can support people as they recover from opioid use disorder. “I think it comes back to movement,” Swisher said. “One of the catchphrases we like to use is, ‘Motion is lotion for the joints.’ And we know that regular physical activity releases the body’s own opioid chemicals. That’s the so-called ‘runner’s high’ that makes us feel good. Physical therapists can partner with people to work through their barriers to becoming more physically active.” What are some of those barriers? Well, it depends. An overweight patient may find movement difficult because he has knee pain. A patient recovering from hip surgery may fear the pain of exercise so much that she avoids attempting it. And a new mom may find caring for her baby so overwhelming that even a walk around the block feels herculean. “Pain is always a perception,” Swisher said. “It is always influenced by your own experiences, your motivation. If you get a tattoo to celebrate something monumental, you’re causing tissue damage, but you don’t perceive that as painful as putting your hand on the stove accidentally. We’re educating our students–and our colleagues–to understand that whole context working with pain.” As described in the article, she and her team also incorporated their model into the clinical rotations that DPT students complete in rural Appalachian communities. As part of their rotations, the students choose a topic to develop into an educational program for a specific population in their community. They research issues specific to that community and consider those issues when designing the program. “So, you get a small group of students who love women’s health,” Swisher said. “Maybe they develop an exercise program for women who have had babies that might have chronic pelvic pain.” All of the programs are stored electronically so that as the students make their way through their rotations, they can access each other’s programs and work with their own clinical supervisors to tailor them to the communities they’re serving. “I think when we’re looking at any kind of healthcare provider going into these rural communities that are really struggling with addiction, you have to look at those psychosocial and emotional reasons why people might find a desire to escape some pain, whether they perceive it as physical pain or whether it becomes more of an emotional pain,” Swisher said. “We have to consider how we as physical therapists interact with people as complex, bio-psychosocial individuals.” The complex, bio-psychosocial individuals who call Appalachia home have been disproportionately affected by the opioid crisis. Appalachians are more likely to die prematurely than people who live elsewhere in the United States, and opioid-related deaths are a main reason for this disparity, reports the Appalachian Regional Commission. West Virginia, in particular, has been hit hard. In 2018, the state had the nation’s highest rate of opioid-involved overdose deaths, according to the National Institutes of Health. That same year, healthcare providers in the state wrote 69.3 opioid prescriptions for every 100 West Virginians. The national average? Just 51.4. Preparing the next generation of physical therapists to deal with opioid use disorder is important because “there’s such a huge issue here in Appalachia, especially in rural communities,” Swisher said. “If you’re a physical therapist, you don’t need a special certification in opioid recovery to influence something across this whole addiction spectrum,” she said. “Just do the things that you do as a physical therapist, in your area.” To read the original article click here.

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A Prescription for the Pain of Rejection: Acetaminophen and Forgiveness

AHA Publisher — Thu, 20 Feb 2020 08:00:48 +0000

University of California – Los Angeles Health Sciences via EurekAlert – Research suggests the combination may alleviate the emotional and physical pains of being excluded. Most everyone experiences the pain of social rejection at some point in their lives. It can be triggered by the end of a romantic relationship, losing a job or being excluded by friends. The emotional distress that often accompanies these experiences is called social pain, and it may cause sadness, depression and loneliness, as well as actual physical pain, research has shown. A study, published recently in the Annals of Behavioral Medicine may have found an antidote – forgiveness combined with acetaminophen, the active ingredient in Tylenol. For the study, researchers followed a group of healthy adults for three weeks and randomly assigned them to receive daily doses of either 1,000 mg of acetaminophen, 400 mg of a placebo potassium pill, or no pill. They also measured their levels of forgiveness on a daily basis using a questionnaire. For example, participants were asked to rate how strongly they agree or disagree with statements, such as, “I hope this person gets what’s coming to them for what he/she did to me.” George Slavich, PhD, director of the UCLA Laboratory for Stress Assessment and Research, a senior author on the study discussed the results. What Is the Key Takeaway from This Study? When combined with a tendency to forgive, taking acetaminophen substantially reduced how much social pain people felt over time. More specifically, participants taking acetaminophen who were high in forgiveness exhibited an 18.5% reduction in social pain over the 20-day study period. What made researchers think that acetaminophen and forgiveness might ease the pain of rejection? Research has shown that physical pain and social pain are influenced by some of the same biological processes in the brain and body. Based on this research, we thought that acetaminophen, which is commonly used to treat physical pain, might also be able to reduce social pain. Based on the study’s findings, what is it about acetaminophen and forgiveness that help alleviate social pain? Do they act synergistically? We think they help reduce experiences of social pain in different ways. For example, acetaminophen likely reduces social pain by influencing pain signaling in the brain through its effects on specific brain pathways. On the other hand, forgiveness has been found to lessen peoples’ feelings of stress and anger following experiences of social rejection and exclusion. Based on the findings from our study, it appears as though acetaminophen acts synergistically with peoples’ ability to forgive to alleviate the feelings of social pain that are commonly associated with rejection and exclusion. How Does Social Pain Affect People Emotionally? Experiencing a socially painful life event, like a relationship break-up, is one of the strongest predictors of developing depression in adolescence and adulthood. Social pain is also associated with decreased cognitive functioning and increased aggression and engagement in self-defeating behaviors, like excessive risk taking and procrastination. Why Does Social Rejection Also Cause Physical Pain? We can only speculate about why social rejection causes physical pain, but one possibility is that physical pain alerts the person to the fact that an important social relationship has been threatened or lost. This may motivate the person to try to rekindle the relationship or form other relationships to help ensure continued safety and survival. Are There Further Studies Planned? Looking forward, we hope to better understand the mechanisms underlying how acetaminophen and forgiveness alleviate social pain and, most importantly, how we can use this knowledge to enhance human health and wellbeing. To read the original article click here.

The post A Prescription for the Pain of Rejection: Acetaminophen and Forgiveness appeared first on Amazing Health Advances.

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Pain Is Always a Perception’: Physical Therapy Can Help Prevent, Treat Opioid Use Disorder

A Prescription for the Pain of Rejection: Acetaminophen and Forgiveness