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Most physical therapists would consider themselves experts of the musculoskeletal system. Given that we have expertise in this area, there are many injuries or ailments that can be treated immediately by a PT. Most insurance companies no longer require a referral from a physician to start PT, and if after a PT evaluation and treatment, further intervention is required by a physician, then the therapist can help guide you to the appropriate referral. Here are some of the conditions that a PT could see first.

1) Recurrence of a past problem that was successfully treated by PT. If you have had a flair up of a previous problem that you went to PT for, then it is often unnecessary to see a doctor that is most likely going to send you back to therapy. The therapist should be familiar with your case and often the same treatments that worked last time will work again. This is especially common with flair ups of back and neck pain.

2) Muscle strains. Many times, these injures are associated with slipping or an athletic injury in an event. PTs are especially good at treating soft tissue injuries such as, muscle strains, and they have multiple options to make it feel better; like laser, massage, dry needling, E-stimulation and ultrasound. The faster the treatment starts the faster patients can start to feel better.

3) Ankle/knee sprains. These rarely require surgical intervention and often respond well to therapy. If the patient is able to weight bear on the injured joint for multiple steps and it is improving, then further treatment from an orthopedist is not likely. Though it is important to point out that some of these sprains can be difficult to truly evaluate until the swelling goes down. Often once the PT is able to help the patient get the swelling to decrease then a referral to a surgeon might be indicated if they suspect any tearing of ligaments.

4) Arthritic joint pain. Arthritis very common in the aging population. Many of these patients know they have an arthritic joint because they have been told so by a doctor on a previous visit. This does not require another appointment to diagnose the same problem. Many of these arthritic joints are not bad enough for replacement, but will
respond to over the counter anti-inflammatories, stretching and strengthening. The stretching and strengthening piece of the program is something that PTs prescribe every day and are experts at managing. Save your time and money and avoid the same diagnosis from the doctor that you have gotten before and go straight for immediate treatment.

5) Back/neck pain. Back and neck pain that has come on suddenly can be very painful. In many cases, this is caused by disc bulging and should be treated immediately because of the pain and suffering it can cause. Many PTs have had extensive training in the treatment of disc problems and if anyone has had nerve pain associated with the problem you know how painful this can be. Treatments include traction, manual therapy, and directional preference stretching to decrease the disc irritation on the nerve. Patients will also need extensive education about postures to avoid in order to
prevent the problem from getting worse.

If you or a loved one is suffering from any of the above-mentioned ailments, don’t hesitate to call your family PT and ask for an evaluation. These are ailments that we deal with every day and would be happy to quickly treat in an effort to get you back to full function as quickly and cost effectively as possible!

Family Medicine doctors are seen as an integral part of the healthcare delivery model because they are on the front lines treating patients, and whole families in some instances. They are seen as necessary to keep healthcare costs down because they help prevent problems from becoming severe and keep people from flooding the ER for every small event that takes place. The job of the family medicine practitioner is difficult because they seemingly need to know a little bit about everything. It is their job to manage some of the chronic ailments and refer out when people need more specialized care. This model seems to work well and I think it should be expanded.

The family practitioner model should be exported to the physical therapy world as well. The only difference would be that physical therapists would manage the numerous musculoskeletal pains that happen over a lifespan and the doctors would continue to handle everything else. I often hear from patients that they have a problem, but they will wait to bring it up with their doctor at their yearly or 6-month checkup. If PTs did checkups on people on a yearly or every 6-month basis, they could address many of the musculoskeletal issues that go untreated but cause dysfunction and limitation of activities.

When there is sickness in a family what do most people think to do first? Call their doctor to see if they can get in quickly to get medicine or treatment to find out what is going on. PTs could easily serve the same purpose for families. If you have a non-emergent issue such as acute back pain, a twisted ankle, or knee pain your family PT should be able to get you in within 24 hours to figure out how it should be managed. Management of these types of conditions rarely require a doctor and should ultimately be managed by a PT anyway. If we can adopt this model of healthcare with physical therapists for the musculoskeletal system, we could have a positive effect on reducing medical costs.

My message is clear! If you are an outpatient PT you should be offering your services to families and friends as a way to help manage aches and pains while decreasing unnecessary medical costs. If you are a potential patient you should make an effort to build a relationship with a local PT that will be there when needed to help you or your family members get out of pain quickly, efficiently and with a minimum spent on unnecessary visits, procedures, and tests.

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