Photo Credit: Vittorio Gravino
Dr. Brockway reviews non-pharmacological interventions, such as physical therapy, for pain management in COPD.
Patients with COPD frequently endure pain, yet clinical guidelines often lack comprehensive recommendations for managing it, as highlighted in a study published in Respiratory Medicine. Analyzing 32 guidelines, Kaelee Brockway, PT, DPT, EdD, and her colleague found that while 24 mentioned pain, only 13 provided treatment recommendations. Suggestions included opioids, pharmacological management, and further medical assessment, but the guidelines varied widely and didn’t consistently align with current evidence.
Dr. Brockway stressed the importance of acknowledging and addressing pain in COPD patients, whether directly linked to the disease or not. Standardizing pain management practices and reducing treatment variability are crucial. Referrals to healthcare providers proficient in pain management can enhance COPD patients’ quality of life.
Pain may stem from COPD or its treatment, with factors like muscle spasms or cough-induced injuries contributing. She notes that guidelines often overlook holistic pain management, failing to recognize non-COPD-related pain sources, like osteoarthritis.
Regarding opioid use, Dr. Brockway acknowledged their potential role but advocates for exploring nonpharmacological and alternative pharmacological interventions due to opioid-associated risks like constipation and pain sensitization. She emphasized the importance of optimizing cough management, a common cause of pain in COPD patients, through non-opioid pharmacological methods and physical therapy interventions.
Dr. Brockway highlighted physical therapists’ unique role in pain management within COPD care, focusing on restoring mobility, improving aerobic capacity, and addressing cough management.
Dr. Brockway emphasized that palliative care encompasses disease management, including COPD-related impairments and comorbidities like kidney issues and heart failure. She critiques guidelines that view palliative care as a separate service, advocating for integrating it into existing care frameworks to minimize patient burden and maximize service efficiency.
Non-pharmacological interventions, often overlooked in guidelines, play a pivotal role in pain management for COPD patients. Dr. Brockway underscored physical therapy’s ability to address musculoskeletal issues associated with COPD, such as structural chest changes, which contribute to pain and breathing difficulties. She stresses the importance of effective cough management, highlighting physical therapy’s role in maintaining airway clearance without suppressing the cough reflex.
Reducing variability in pain management recommendations requires interdisciplinary collaboration and communication among healthcare providers. Dr. Brockway emphasizes the need for representation from various specialties in guideline creation teams to ensure comprehensive and cohesive care approaches.
To improve pain management for COPD patients, Dr. Brockway advocates for streamlined referral processes to appropriate providers, with physical therapists playing a central role in non-pharmacological pain management. She cited the US Department of Health and Human Services guidelines emphasizing non-invasive conservative care and positions physical therapists as frontline providers in pain management. Dr. Brockway emphasized a team-based approach, where both physicians and therapists collaborate to ensure patients receive optimal care tailored to their needs.
Stay tuned for a two-part interview with Physician’s Weekly and Dr. Brockway.
