Physical Therapy Reduces Depression & Addiction in Veterans

In December of 2018, the US Department of Veterans Affairs (VA) established a partnership with the American Physical Therapy Association (APTA) to offer Veterans new physical therapy resources. “Physical therapy is an important resource for improving Veterans’ health and well-being,” said Robert Wilkie, VA Secretary. Since then, studies have been conducted to measure physical therapy's effectiveness for veterans' physical and mental health. One study from the Journal of General Internal Medicine found that there is a reduced risk of negative outcomes among veterans who received non-drug treatment for ongoing pain.

The study showed that veterans who received physical therapy had a much lower risk of:

• alcohol or drug use disorders

• overdose on opioids, related narcotics, barbiturates, or sedatives

• self-mutilation, suicidal thoughts, and suicide attempts

The VA, the National Institute on Drug Abuse, and the National Center for Complementary and Integrative Health funded this research.

Methods of Study

Dr. Esther Meerwijk, statistician and suicide researcher, of the VA Palo Alto Health Care System, led the study with colleagues. The team analyzed health records of over 142,500 active service members in the Army who had persistent pain after deployment to Iraq or Afghanistan from 2008 to 2014. The median age of the group was 26 and their average deployment lasted at least one year.

The most frequently reported chronic pain included pain of the joints, back, neck, muscles, or bone.

The scientists recorded the duration of each person's treatment, the drug or non-drug therapies that they had received, and how many days patients had taken opioids.

The analysis included the following non-pharmaceutical therapies, and among the group, 92.2% had received exercise therapy. Other non-drug therapies included:

• alternative forms of physical therapy: 32.4%

• chiropractic treatment: 23.5%

• electrical stimulation: 20.3%

• massage therapy: 17.6%

• spinal manipulation: 12.0%

• acupuncture: 10.2%

Analyzing Outcomes

The research team reviewed the negative outcomes by assessing each patient's medical history after their service term ended and switched to VHA care.

The results showed a decrease in negative outcomes among those who had received PT, and the most remarkable data point was a 35% decrease in the risk of overdose with opioids, narcotics, barbiturates, or sedatives.

In addition, the researchers observed that the non-pharmaceutical therapies group:

• were 17% less likely to self-mutilate

• were 12% less likely to consider suicide

• were 8% less likely to experience addiction to drugs or alcohol

“If non-drug treatments make chronic pain more bearable, people may be more likely to have positive experiences in life. That makes them less likely to have thoughts of suicide or to turn to drugs,” Meerwijk proposes. Considering the VA’s interest in this study and its findings, Meerwijk is optimistic that the benefits of non-drug therapies for constant pain will lead service member medical authorities to turn to non-opioid alternatives on a regular basis.