Where to Go First When Something Hurts

Posted December 16, 2021

If you’re experiencing musculoskeletal pain, it can be confusing trying to figure out where to go first. Primary care physician? Physical therapist? Specialist? Urgent care? Let’s break it down.

First off, what exactly is musculoskeletal pain, and how do I know when I need to see someone for it?

Musculoskeletal pain is pain that affects your bones, joints, ligaments, muscles, or tendons. And there are a lot of variations. It may be limited to one area of your body, or it could be present in your entire body. Sometimes, perhaps as the result of a recent injury, the pain can be sudden and severe (acute) or, in other cases, it can be long-lasting (chronic.)

If that pain interferes with your mobility and function or prevents you from working, enjoying your favorite activities, or participating in your daily life, it’s time to see someone.

Got it. So where should I go if I’m in musculoskeletal pain?

Your physical therapist. Here’s why:

Your physical therapist can diagnose musculoskeletal injuries with the same amount of accuracy as an orthopaedic surgeon. In the United States Army, patients with musculoskeletal issues are frequently seen first by physical therapists. So, researchers wanted to test if there was any difference in their diagnostic accuracy vs. orthopaedic surgeons, and published their results in the most prestigious journal in orthopedic physical therapy, Journal of Orthopaedic and Sports Physical Therapy. The results? Clinical diagnostic accuracy by physical therapists and orthopaedic surgeons on patients with musculoskeletal injuries is not statistically different. And, both providers had significantly greater accuracy (double!!!) than that of nonorthopaedic providers.
It gets you better, faster. If your first stop is your primary care physician, they will likely refer you to an orthopaedic specialist, who would then send you for physical therapy. Given that the average wait time to see a physician or specialist is 24 days, that process alone could set you back several months. Why wait when you could go straight to the source?
It costs you less. The right physical therapy within 14 days of the onset of low back pain minimizes the average total episodic cost of care by 50%, because it reduces the need for additional healthcare services. These costs are saved by avoiding surgery, imaging, and prescription medication.

So, can I see a physical therapist without a physician’s referral or prescription?

Yes, you can! It’s called direct access. And, luckily, it saves you from having to jump through a lot of hoops. Our goal is to ensure that each of our patients receive the highest quality of care available, and quickly.

Cool. So how long will I need to see my physical therapist, and what happens when I’m there?

It depends on the underlying cause of your musculoskeletal pain. Your first visit, also known as your initial evaluation, will be about an hour long. During that time, your physical therapist will talk with you about your pain, your limitations, and your goals. They’ll also walk you through a few tests and take measurements to establish a baseline for where you’re starting.

Before you leave the initial evaluation, your physical therapist will take some time to educate you on what’s going on, how many visits you’ll likely need, and what you can expect from a treatment plan.