Emerging Non-Opioid Pain Treatment & Physical Therapy

Medically reviewed by Misty Seidenburg

While opioids were once the go-to solution for managing chronic pain, there’s a growing recognition of the need for safer, non-opioid pain treatment options. Today, physical therapy and other evidence-based strategies are leading the way in providing non-opioid pain relief.

Let’s explore some promising alternatives to opioids, with a focus on how physical therapy supports individuals in managing pain effectively, without dependence.

The Need for Opioid Alternatives

Opioids can offer short-term pain relief, but their risks are well-documented:

• These medications often come with serious side effects, including sedation, nausea, and constipation.
• Long-term use can lead to tolerance, requiring higher doses to achieve the same effect.
• In many cases, they can lead to physical dependence or even addiction.
• In 2024 alone, there were an estimated 80,000+ opioid-related overdose deaths across the U.S.

As awareness of these risks grows, so does interest in non-opioid pain management solutions. Current CDC guidance encourages the use of physical therapy, cognitive behavioral strategies, and other interventions as first-line treatments for many types of pain.

How Physical Therapy Supports Non-Opioid Pain Relief

Many people with musculoskeletal or nerve-related conditions benefit from a structured, drug-free approach. One research study of over 88,000 participants found that early physical therapy reduced opioid use by 10% in individuals with musculoskeletal pain.

Physical therapy can be a powerful pain-management tool for a few reasons:

•  Root-cause analysis: A physical therapist evaluates posture, movement, muscle strength, and pain processing to identify the underlying cause of pain for targeted treatment.
• Safe, therapeutic movement: Exercises and stretches are designed to enhance strength, flexibility, and capacity, reducing strain on painful areas for greater comfort.
• Functional movement training: Physical therapy often incorporates real-world motions (like squatting, reaching, or walking) to improve everyday activities and reduce pain during daily tasks.
• Education: Patients acquire tools and skills to manage pain through improved movement patterns and pacing strategies, building capacity to help them feel more informed and in control of their condition.

Physical therapy is more than exercise. It’s a comprehensive, personalized approach to chronic pain treatment that helps clients restore movement, improve function, and better understand how to manage their condition.

Evidence-Based Physical Therapy Treatments

A well-rounded physical therapy plan offers a variety of techniques and treatments designed to support effective chronic pain management. Here are some of the most commonly used approaches.

Therapeutic Movement

Physical therapists guide clients through progressive exercise routines that help build strength and flexibility, reduce stiffness, enhance endurance, and support better posture and movement efficiency. These exercises are tailored to each individual’s needs and can be easily adjusted as needed over time.

Targeted Modalities

Movement alone isn’t always enough to address symptoms. Many clients have improved outcomes with:

• Transcutaneous Electrical Nerve Stimulation (TENS): a safe, non-invasive way to stimulate nerves and reduce pain perception.
• Dry needling: used to release muscular trigger points, improve range of motion, and decrease pain signals.
• Laser therapy: helps stimulate healing and reduce inflammation in soft tissue injuries.

 These techniques are often used alongside exercise and manual therapy to support a more comprehensive pain management plan.

Manual Therapy

Manual therapy is a hands-on approach used to relieve pain, improve mobility, and restore function. These techniques involve skilled manipulation of muscles, joints, and soft tissues, helping to reduce tension, improve circulation, and encourage healing.

Common methods include joint mobilization, where therapists gently move joints to improve range of motion, soft tissue mobilization, which targets tight muscles and fascia, and myofascial release, which focuses on loosening connective tissue.

These techniques can be particularly beneficial for clients experiencing chronic pain, stiffness, or limited mobility. When used alongside exercise and other non-opioid pain treatment strategies, manual therapy supports a more holistic approach to pain relief and recovery.

Education and Self-Management

Personal empowerment is one of the most powerful outcomes of physical therapy. People often leave treatment not only with reduced pain but also with the knowledge and tools to manage flare-ups and avoid re-injury.

Self-care pain management strategies can include a customized home exercise plan, stretching and body mechanics training, as well as mindfulness or relaxation techniques. Clients learn pacing strategies and methods to systematically build their capacity for activity. By actively participating in their care, clients can often reduce or eliminate the need for pain medications.

Chronic Pain Assessment: The First Step Toward Relief

If you’re considering non opioid pain treatment, the first step is a personalized evaluation by a licensed physical therapist.

Here’s what you can typically expect from your first visit:

1. Health history: Your physical therapist asks about your overall health, pain patterns, injury history, activity level, and current medications.
2. Functional movement screening: Assessing posture, flexibility, and muscle imbalances helps your physical therapist target specific problem areas.
3. Collaborative goal-setting: Treatment is aligned with your personal goals, whether that’s walking without pain, returning to work, or improving daily mobility.

After this initial assessment, your physical therapist designs a customized treatment plan based on your specific needs, goals, and how your body moves. As your progress is monitored, your therapist adjusts your program to ensure it remains effective and aligned with your recovery.

This individualized approach is key to making meaningful strides in managing chronic pain without reliance on medication.

Physical Therapy: A Safer Path to Relief

While opioids may still have a place in specific acute or palliative care settings, they are no longer the default for chronic pain treatment. Safer, smarter, and often more sustainable physical therapy options now exist, and non-opioid pain management strategies like physical therapy are leading the way. It’s a personalized, evidence-informed approach that focuses on healing—not masking physical symptoms.

Taking the first step toward non opioid pain relief could open the door to better mobility, less pain, and greater independence, without relying on medications. Find a physical therapy clinic near you to get started.