Imagine you tweaked your back or knee a month ago and it hasn’t gotten better. Maybe you’ve seen your doctor and are waiting to see a specialist, as is often the case.
Two things are happening at this point, neither of them are good.
First, if your pain was caused by a muscle, tendon or ligament injury, it’s probably gotten worse by now. That initial injury has the potential to transition to a chronic, or long-term, issue.
If the pain continues for longer than 12 weeks and begins to limit the activities you once enjoyed, you may also be coping with anxiety or depression.
Second, your wallet has taken a hit. Even if you have insurance, the X-rays, prescriptions and office visits have probably come with copays and other costs.
So, what’s at the end of this road? In rare cases, surgery, injections or other procedures. However, most of the time, common causes of pain are treated with physical therapy.
If you went to the physical therapist first, you could have avoided most of those costs and probably fixed the underlying problem earlier.
“Coming straight to a physical therapist lets us help you much more quickly for a lower cost of care,” said Holly Myers, MPT, MBA, director of AdventHealth outpatient rehabilitation at Altamonte Springs since 2005. “Seeing your physical therapist first has been shown to reduce the chances of receiving an x-ray, MRI or prescribed opioids, which decreases downstream health costs.”
A recent study on patients with neck pain backs up that contention.
What the Study Says
The researchers divided the patients into three groups:
- An “early” group that saw a physical therapist within two weeks or less of their first visit to a health care provider.
- A “delayed” group that waited between 15 and 90 days to see a physical therapist.
- A “late” group that waited between 91 days and a year to see a physical therapist.
The people who saw a physical therapist earlier were better off. Here are some of the key findings:
- Over the following year, people who saw a physical therapist early had average total health care costs of $1,853. That’s about $1,000 less than the delayed group and half as much as the late group.
- Patients in the late group were almost three times as likely to receive an opioid prescription as the early group.
- People who saw a physical therapist late ended up seeing doctors or other providers for 319 days, compared with 49 days for the early physical therapy group. That suggests their problem was fixed sooner.
- People who waited to see a physical therapist had more trouble with chronic pain, more substance abuse and more tobacco use.
Long-term pain can also lead to depression and anxiety as patients avoid the activities they once enjoyed, said Michelle M. Ramirez, PT, DPT, OCS, orthopedic research manager at AdventHealth Sports Medicine and Rehab.
“We have a dialogue with patients about their fear of getting back to normal activities and offer them resources in our community if they need more help,” she says.
Now that you know what you can avoid by seeing a physical therapist early, here’s what to expect.
What to Expect
The first step of a physical therapy visit is a conversation, Myers says. They’ll ask how your pain started, whether it’s happened in the past and what you’ve tried.
The examination itself is called a “biomechanical screening,” and it’s the physical therapist’s way of looking at how you move. The physical therapist will probably want to see how you walk and, if you’re a runner, may ask you to step on a treadmill and jog.
Then it’s onto a closer look at the parts of your body that are giving you trouble. That includes a look at the nearby joints, as well as your range of motion, or how much a joint can move compared with its full potential.
Instead of using an X-ray or other image to look for a problem, a physical therapist will use a physical examination to figure out what’s wrong, Myers said.
Eric Specht, MPT, director of operations at AdventHealth Sports Medicine and Rehab outpatient rehabilitation, says X-rays and similar tests for spinal pain will often show problems with the cushioning, or discs, between our spines. But that doesn’t mean this is where the pain is coming from.
“They may find a herniated disc, but that disc may also have nothing to do with your pain,” he said.
Throughout the process, physical therapists are on the lookout for red flags — indications that a patient’s pain has a different, and potentially more serious, cause.
In other words, physical therapists are trained to figure out when pain is caused by something other than a bone, muscle or movement issue. If that happens, they can send you right to a physician who can help.
Even without those red flags, physical therapists believe in making a connection with a patient’s primary doctor to keep them in the loop.
“We’re making a connection to the primary care physician so they still feel connected to their patient and know what’s happening to them,” Ramirez says.
Instead of prescribing medicine, a physical therapist is more likely to prescribe movement. After all, while medication can mask a problem, the right movement can heal it, says J. Leigh Harris, PT, DPT, senior manager of outpatient rehab at AdventHealth Sports Medicine and Rehab.
“A pill will mask your symptoms and unless you correct the root problem, it’s going to come back,” she says.
Pain can feel like a puzzle, and AdventHealth believes that whole health comes from putting all the pieces together — the physical, emotional and spiritual.