Neuromuscular Therapy as an Alternative to Opioid.
Prescription opioids carry serious risk of addiction, abuse, and overdose, in addition to a number of side effects, even when taken as directed. According to the Centers for Disease Control, deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999.
For that reason, a number of health organizations and governmental agencies are seriously looking at alternative ways to manage pain.
The American Massage Therapy Association (AMTA) continues to be actively engaged with several organizations, as well as federal and state governmental agencies regarding massage therapy for pain and specifically an an alternative to opioids.
Clinical Recommendations
Academy of Integrative Pain Management
Helping Government Address Opioid Use
Research and Resources
In the News: Massage as an Alternative to Opioids
August 2018 – AMTA began an outreach effort with approximately 700 Medicare Advantage insurance companies encouraging them to follow the Center for Medicare Services recommendations by covering medically-approved massage therapy provided by state licensed massage therapists. While coverage of massage therapy is not automatic, AMTA is asking Medicare Advantage plans to consider since 2018.
August 2018 – AMTA published Massage Therapy in Integrative Care & Pain Management, a detailed overview of research on the efficacy of massage therapy and results of an economic modeling indicating that using massage therapy instead of opioids for specific types of pain, could save the U.S. between $23 and $25 billion each year.
Fall 2017 – AMTA met with a representative and provided feedback to the FDA regarding the important role massage therapy can play. The FDA released guidelines calling on health care providers to be informed on the range of therapeutic options for managing pain, including non-pharmacologic approaches and therapies. While the FDA was not specific about these approaches, the National Institutes of Health (NIH) has for several years now, included massage therapy among its list of complementary therapies.
Fall 2017 – The U.S. Food & Drug Administration (FDA) sought public comment on the "FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain".
Fall 2017 – Consumer Reports discussed massage therapy as an approach to low back pain.
September 2017 – 37 US Attorney Generals called for Inclusion of Massage in Insurance Coverage. See the coverage in ABC News, and read the letter.
NBC medical correspondent Dr. John Torres reported on the Today Show that the CDC recommends massage therapy, NSAIDS and acupuncture as an alternative to opioids.
Clinical Recommendations - Massage Therapy for Pain
September 2018 - The final draft of the "U.S. Food and Drug Administration's (FDA's) Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain" includes a recommendation of complementary therapies as defined by NIH/NCCIH. The Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program requires that health care providers receive training on pain management, and should be knowledgeable about the range of non-pharmacologic treatment options available.
April 2018 - The Center for Medicare Services published new guidelines for Medicare Advantage programs coverage in 2019. "Medically-Approved Non-Opioid Pain Management (PBP B13d, e, or f): Medically-approved non-opioid pain treatment alternatives, including therapeutic massage furnished by a state licensed massage therapist. Massage should not be singled out as a particular aspect of other coverage (e.g., chiropractic care or occupational therapy) and must be ordered by a physician or medical professional in order to be considered primarily health related and not primarily for the comfort or relaxation of the enrollee. The non-opioid pain management item or service must treat or ameliorate the impact of an injury or illness (e.g., pain, stiffness, loss of range of motion)." Medicare Managed Care Manual Chapter 4 - Benefits and Beneficiary Protections
The American College of Physicians issued guidelines recommending massage therapy for low-back pain in 2017.
The Federation of State Medical Boards issued recommendations in April 2017 on approaches to pain, including massage therapy among non-pharmacologic therapies.
Since November 2014, The Joint Commission hospital standards for non-pharmacologic strategies for pain included the use of massage therapy. [Joint Commission Perspectives, Volume 34, Number 11, November 2014, pp. 11-11(1). Clarification to Standard PC.01.02.07]
