Opioid Addiction in Adults over 40: a Public Health Emergency

/in , /by

The COVID-19 pandemic has been top of mind for months. We’ve all experienced some major curveballs this year, and most people have learned a lot about public health and epidemiology along the way. But why now? Why are we finally learning how viruses attack the respiratory system, what it means to be immunocompromised, and the best practices for disinfecting? Maybe it’s because of the unpredictability and common threat associated with this virus. Although some demographics have an increased risk of serious outcomes, anyone can get this novel coronavirus and anyone can become ill. 

Unfortunately, Covid isn’t the only public health crisis facing Americans in 2020.

The opioid epidemic has been in the news for years, but many of us don’t bother to take precautions or educate ourselves because we don’t think opioid addiction can happen to us.   

That couldn’t be further from the truth!

Anyone can become addicted to opioids. Many of the Americans battling addiction right now don’t have a history of drug abuse. Instead, what they have in common is something relatively routine. They deal with chronic pain or they had a surgery, and a physician prescribed them opioids.

According to the US Department of Health and Human Services, “opioid overdoses accounted for more than 42,000 deaths in 2016” and “an estimated 40% of opioid overdose deaths involved a prescription opioid.” Between 2010 and 2016, opiate prescriptions from surgeons rose by over 18 percent (UCI Health). And according to the National Institute on Drug Abuse, approximately 21 to 29 percent of patients who are prescribed opioids by physicians end up misusing them. Eight to 12 percent become addicted (NIDA). And the reality of opioid addiction is sobering. In 2017 alone, over 47,000 people in the United States overdosed on opioids and died. 

In 2017, the opioid epidemic was declared a public health emergency.

A public health emergency is just that — public! The emergent status of this crisis is not limited to one demographic or “type” of person. Although media attention through TV and movies tends to focus on heroin and young people getting high, data from the Substance Abuse and Mental Health Services Administration tells us that 63.4% of the adults who misused prescription opioids in 2015 did so to relieve legitimate physical pain. Chances are, we’ve all felt pain at one time or another that ibuprofen or tylenol alone couldn’t get rid of. Everyone is at risk for opioid addiction because anyone could get in a car accident, or require surgery, or develop arthritis. 

Pain-relieving drugs like Oxycodone, Oxycontin, Vicodin, Percocet, and others can be extremely helpful in some circumstances. But unfortunately, they are often overprescribed thanks to aggressive incentivising and pressure from drug manufacturers. The fact that opioids are so often prescribed after surgery and for patients with chronic pain means that middle aged and older adults are at a higher risk for drug addiction than ever before. In 2016, 14.4 million adults on Medicare (age  65+) had at least one opioid prescription (Consumer Voice). Older adults are also more sensitive to the physical effects of opioids. Side effects such as respiratory depression and cognitive impairment increase in severity as the patient’s age increases, often leading to hospitalizations and even deaths. 

So many clients in our practice fall into this at-risk demographic.

We have countless clients coming to us with severe chronic pain. Some have already had surgeries or been told that surgery is their only route to a pain-free life. Many have considered opioids to treat their back pain. And we are so grateful that we’ve been able to help hundreds of individuals recover from their injuries AND chronic pain without resorting to drugs, surgery, or both!

We promote both physical therapy and Pilates as alternatives to surgery and for preventing painful musculoskeletal problems because they truly work.

We recognize that most knee, back, and other injuries occur because the surrounding muscles are too weak to support those joints and systems properly — and we have the expertise to retrain your body in correct movement. You may think that your regular exercise and stretching is enough, but oftentimes working specific muscle groups leaves others underdeveloped and your body unbalanced as a whole. Our team of specialists is trained to create individualized solutions for your particular needs, because we believe that movement is medicine — when it’s prescribed properly! The idea of a quick fix is tempting — but a quick fix can easily turn into long term opioid addiction, illness, and even death. Taking the time to teach your body how to heal itself is so much more rewarding in the long run.

Want to learn more about how we can work with you to determine the safest, strongest, most effective route to recovery? Just click here to sign up for a FREE Discovery Session with one of our specialists.

 

This article was authored by Katya Engalichev. Katya is a pharmacy technician, EMT, and graduate student who writes for CJ Physical Therapy & Pilates. 

Carrie working on a client's shoulder

Shoulder Pain not Going Away? This could be why…

/in /by

Whether it’s shoulder pain, neck pain, back pain, or knee pain that you’re dealing with — if you have a nagging pain or injury that just won’t go away no matter what you try, it’s a clue that you’re missing something.

We see this ALL the time in our office with shoulders.

Folks just like you come to us wondering why their shoulder still hurts after trying ice, heat, rest, physical therapy, massage, and every possible shoulder exercise you could imagine.

The pain either goes away temporarily, or sometimes it gets WORSE!

When it comes to shoulder pain, it’s critical that you know for certain if the pain is actually coming from your shoulder, or somewhere else. If not, you risk trying to fix the wrong problem… and that explains EXACTLY why your shoulder pain isn’t going away.

So… if your shoulder pain isn’t caused by your shoulder — where is it coming from?

The most common culprit is actually your NECK. Below are a few key signs to help you figure out if that’s the case…

(PS – we’re doing an online workshop on this topic in just a few weeks.)

Where is your pain?

When your pain is coming from your shoulder, the pain will always be localized to your shoulder alone. True shoulder pain is felt directly in front of your shoulder, directly on top, or in a more involved shoulder problem (like a rotator cuff injury) you might feel some achiness down the side of your arm… but it will never go below your elbow.

If the pain goes past your elbow and into your forearm or hand, or radiates above your shoulder into your neck (the upper trap area), or if you feel it deep inside of your shoulder blade in your mid-back, odds are pretty good that you’re dealing with a neck problem and not just a shoulder problem. This could be the reason why your shoulder pain isn’t going away.

Do your symptoms involve numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening, it’s likely coming from your neck – and could be due to a bulging disc or a restricted/faulty movement pattern that is irritating nerve roots in your neck. An isolated shoulder problem typically does NOT involve nerve root compression or irritation. This is much more common in a problem related to your neck, and if that’s what’s happening, you will feel symptoms into your shoulder, shoulder blade, or even down into your arm. What’s particularly misleading is that it’s entirely possible to feel all these nerve symptoms and not actually feel anything localized to your neck. This is a big reason why shoulder pain caused by a neck issue gets missed by so many health practitioners.

Have you lost mobility or range of motion?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well and is pain free, but your shoulder is stiff and immobile, odds are good that the problem is actually in your shoulder and you just haven’t found the right treatment approach yet. BUT… if you have a stiff and painful neck, and you lack mobility in your shoulder, then it’s absolutely imperative that you investigate your neck. If your care provider only focuses on stretching and improving your shoulder mobility, and never bothers to look at your neck, it’s possible you could be missing a key component to full recovery… and that’s why your shoulder pain keeps coming back.

 

4 Tips to Save your Neck and Back During Summer Road Trips

/in /by

Now that summer is in full swing, but a lot of people don’t feel comfortable flying, many of us are planning road trips for those special summer getaways! It’s always fun to hit the road and explore a new place — but first, let me help you out with some tips to save your neck and back…

(For more tips – check out our Free Guides section on our website and also join us for our next virtual workshop all about neck and shoulder pain!)

Tip #1: Interrupt your sitting

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting. Our bodies are made to move continuously throughout the day. Too much sitting puts extra load and compression on your spine, and can trigger an underlying problem you weren’t even aware of.

On road trips, getting out of your seat is critical for keeping your neck and back healthy. Try to plan extra time in your trip to pull over at rest stops and walk around. We recommend interrupting your sitting every 30 minutes for good neck and back health. I understand keeping up with that frequency on a long road trip is difficult, but something is better than nothing! You’ll want to capitalize on your rest stops by moving around instead of sitting.

Tip #2: Use a lumbar pillow

A proper lumbar pillow is not only essential for good lower back alignment while sitting, but also for proper neck alignment. We have natural curves in our spine that are designed to absorb shock and disperse load. When those curves aren’t maintained, especially for prolonged periods, you get abnormal and unwanted forces throughout your spine – resulting in pain and stiffness.

Ever heard of the dreaded “forward head?”

That’s the posture your neck assumes when it needs to compensate for lower back slouching. We sell lumbar pillows in our office, but you can also try making your own by rolling up a towel or sweatshirt. Just make sure the roll is thick enough to maintain the natural curve in your lower back without much effort while you sit. The built-in lumbar supports that come with your car are typically NOT adequate enough.

Tip #3: Adjust your car seat

This is an often overlooked, but important component to achieve healthy posture while driving. Too often, I see folks driving around with seats that are either too far away or too close to their steering wheel. If you’re too close, it will cause you to sit overly straight or upright, resulting in unnecessary strain in your neck and low back. If your seat is too far back, then it will be virtually impossible to maintain the natural curve in your lower spine, even with one of our lumbar pillows. Your arms will need to overreach for the steering wheel, causing strain in your shoulders. And your neck will assume that forward head posture just to remain upright, causing strain to your neck.

You want to make sure your seat is positioned in a way that allows your neck to be easily balanced on top of your spine and pelvis – without much effort. Your elbows should be at an approximate 90 degree angle when your hands are on the steering wheel, and there should be a relaxed 45 degree bend at your knee so that your foot can easily switch from gas to break without you having to constantly flex your thigh. Having your car seat positioned correctly before you take a long drive will significantly decrease the strain on your neck and back.

Tip #4: Use a neck pillow when you sleep

On road trips – we often sleep on mattresses that are less than optimal and certainly not as comfy as our own. Using a neck pillow while you sleep can significantly decrease morning pain and stiffness caused by poor sleeping postures.

Getting a good night’s sleep and not waking up in pain has a lot to do with the position you sleep in.

Just like with sitting, you want your sleeping position to be as balanced as possible. When you sleep on your stomach, your neck has no choice but to stay turned and extended to one side all night. Prolonged poor postures are not great for any joint in your body, but especially those in your neck. Your neck is the most mobile section of your spine which makes it much easier to “kink” if in a poor position. Sleeping on your back is not terrible, and it’s what many people prefer.., but depending on how firm or soft the mattress you’re sleeping on is… it could be difficult to maintain the natural curves in your neck and back while you sleep. If you sleep in a slouched position all night long, you’ll wake up with pain and stiffness.

If you can tolerate it, my favorite position for sleeping is on your side and with a neck pillow. This allows both your neck and low back to stay relaxed and with their natural curves.

To make a neck pillow, use a small towel roll about 3 inches in diameter and stuff it the long way inside the bottom of your pillow case. When you rest your head on the pillow, it acts like a comfy support to maintain good neck alignment while sleeping on your side. We can also order one for you!