Should I see a Physical Therapist or a Physician first for my pain?

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Time and money are two finite resources especially in today's healthcare environment of rising deductibles and decreased access to primary care services.  Thankfully in Colorado patients have a choice on who to see first for their muscle, tendon, and joint pain.  State law enables Coloradans to see a Physical Therapist without a prior referral.  This care model, direct access, has been utilized since the early 1950's to reduce costs and improve outcomes for patients with musculoskeletal pain.  Currently, fortune 500 companies, the U.S. military, and large hospital systems utilize this model of care due to its' safety, cost and clinical effectiveness, and ability to decrease wait times for patients.  Below is a summary of the latest research comparing cost and prognosis for seeing a PT first for your musculoskeletal pain.

Low Back Pain – 2nd most common reason patients seek medical attention

            Patients save $1996 if they see a PT first vs. guideline based care (Hahne et al. 2016)

            Patients saved $1543 if they saw a PT first before a MD (Denninger et al. 2017)

Neck Pain – lifetime prevalence of up to 70%

            50-75% of patients report symptoms at 1 and 5 yr follow up (Hush et al. 2011, Carroll et al. 2006)

            Patients save $800 if they see a PT first before MD (Korthals de Bos et al. 2003)

Headache

            Manual Therapy more effective than primary care or exercise alone (Hoving et al. 2002, Gross et al. 2004).

            Beneficial effects seen up to 1 and 2 year follow up

Shoulder Pain – 2nd most common cause of musculoskeletal pain

            50% of patients report symptoms at 6 months (Winters et al. 1999)

            Physical Therapy accelerates recovery compared to usual medical care (Bergman et al. 2004)

            Physical Therapy reduces short and long term disability vs. primary care (Peek et al. 2015)

Elbow Pain

            Decreased healthcare utilization and costs with Physical Therapy treatment (Bisset et al. 2006)

            Lowest recurrence rate seen with PT treatments (Coombes et al. 2013)

Hip Osteoarthritis

            Physical Therapy delays need for hip replacement (Svege et al. 2015)
Knee Osteoarthritis

            Physical Therapy accelerates recovery vs. wait and see (Deyle et al. 2000)

            Manual therapy and exercise twice as effective as exercise alone (Deyle et al. 2005)

Ankle Sprains

            72% of patients report symptoms at 6 months (Braun et al. 1999)

            Physical Therapy accelerates recovery vs. rest, ice, compression, elevation (Green et al. 2001)