Is It Time for Physical Therapy?

What to expect if you start physical therapy for your aches and pains.

From the WebMD Archives

You stretch, you run, you lift, you exercise every day, yet something doesn’t feel quite right. Maybe it’s a nagging pain or stiffness in your joints that won’t go away.

Whatever the problem, maybe it’s time to see a physical therapist.

“We help with motion -- whether that’s in sport, in activities, or at work,” says Mary Ann Wilmarth, DPT, chief of physical therapy at Harvard University Health Services.

Physical therapists (or PTs for short) are trained to treat muscle and joint problems, back pain, and other ailments that can make moving difficult. They also help guide exercise programs for patients undergoing cardiac rehabilitation.

Baby boomers make up the bulk of the patient clientele, Wilmarth says. What brings them to her?

“They find that things are not moving the way they used to, and they are not sure what to do about it,” she says.

Wilmarth also says that high school and college athletes frequently find themselves in need of a PT’s attention because of sports-related injuries, as well as back and neck pain. But her patients run the entire life cycle.

“We see everyone from newborns on up,” Wilmarth says. “I have someone in my clinic who is 99.”

What to Expect

At your first appointment, you will undergo an assessment. That will take about 45 minutes.

“We do an exam and come up with a problem list and a plan,” says Scott Euype, DPT, a physical therapist at the Cleveland Clinic.

That exam will include strength tests to determine if your muscles are working at normal capacity, as well as an evaluation of your range of motion and your balance. Those objective measures will help your PT set treatment benchmarks and aid in devising an exercise plan.

Most patients will then see their physical therapist for several visits. Just how many visits depends on the individual’s needs and progress, and the numbers can vary.

“Six to 12 visits is enough to cover most diagnoses,” Wilmarth says, “but even one to two can get people going in the right way.”

The hardest work always comes first, Wilmarth says, as patients start to work toward relieving their pain and building strength.

“We start with an acute program and then work on a plan that they can fit into their everyday life,” Wilmarth says. “We listen and work with their schedule, because if we make the plan too hard, it won’t happen.”

Continued

No Quick Fix

There’s evidence that physical therapy can be more effective than surgery for problems such as low back pain.

But avoiding surgery doesn’t mean that you will have it easy or that a few visits to your PT will cure you.

“Very few injuries need surgery. They need time and work,” says Ryan Petering, MD, a sports medicine specialist at Oregon Health and Science University who often refers patients to physical therapists.

“The physical therapist’s job is to teach people how to move better,” Petering says, “And there are things that you will need to do on your own.”

Euype says the exercises he prescribes for his patients - he calls it homework - have to become part of their regular and ongoing routine, even long after the last physical therapy appointment.

“This is life-long,” Euype says. “This is what got you better, but you have to keep doing it. It’s those exercises that keep the pain at bay. Missing a few days is often enough for it to return.”

Euype and Wilmarth acknowledge that this can be a hard pill to swallow, so they work with their patients to come up with a plan that not only fits into their day but that might actually become enjoyable.

“We negotiate with patients,” Euype says. “The key is keeping it simple. I give my patients no more than two to three new exercises per visit.”

How Much Does It Cost?

What insurance covers varies from plan to plan. Some policies will require that you get a referral from a physician in order to get reimbursed.

Euype says that patients need to take into account not only the number of appointments their policy will allow, but how much their co-pay will be. “Some insurance co-payments are very expensive and can dictate the number of visits,” he says.

So it's best to check your policy before making an appointment. That way, you'll know what's covered and what you'll be paying.

WebMD Feature Reviewed by Louise Chang, MD on June 17, 2011

Sources

SOURCES:

Mary Ann Wilmarth, DPT, Harvard University Health Services, Cambridge, Mass.

Scott Euype, DPT, Cleveland Clinic, Cleveland.

Ryan Petering, MD, Oregon Health and Science University, Portland.

© 2011 WebMD, LLC. All rights reserved.

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