Physical Therapy: Common Questions Answered
Physical Therapy: straight answers to the questions people actually ask, with the figures behind them.
Assessment and treatment of movement problems, largely through exercise and education.
Key takeaways
- Direct access: all states allow some evaluation or treatment without a referral, with limits that vary by state
- Insurance: some plans still require a referral or limit the number of visits
- Most useful single change: Check your state rules and your insurance before booking directly.
- Commonest mistake: Expecting passive treatment alone to resolve the problem.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What is Physical Therapy?
Assessment and treatment of movement problems, largely through exercise and education.
Why does it matter?
In every state you can see a physical therapist without a referral in at least some circumstances, which most people do not know.
Direct access for Physical Therapy?
All states allow some evaluation or treatment without a referral, with limits that vary by state.
Main treatment for Physical Therapy?
Graded exercise and education.
Hands-on therapy for Physical Therapy?
Most useful as part of a plan that includes exercise.
What is the single most useful thing to do?
Check your state rules and your insurance before booking directly.
What is the most common mistake?
Expecting passive treatment alone to resolve the problem.
When should I see a doctor?
Go to the emergency room rather than physical therapy for numbness around the genitals, buttocks or inner thighs, bladder or bowel changes, or weakness in both legs, and call 911 after a serious injury. See your doctor promptly for pain with fever, unexplained weight loss, a history of cancer, or progressive limb weakness.
More questions, answered
Do I need a referral to see a physical therapist?
All states allow some form of direct access, but rules vary and some limit the number of visits or time without a referral. Your insurance may also require a referral. Check your state rules and plan.
How many sessions will I need?
It depends on your condition, goals and progress. Some problems need only a few visits with a home program, while others require longer treatment. Your therapist will give an estimate and review it as you progress.
Is physical therapy painful?
Some exercises may cause mild discomfort, especially early on, as you ask tissues to do more than they are used to. Treatment should not cause severe pain or pain that lasts long after the session. Mild soreness that settles within a day is common. Tell your therapist if something hurts so they can adjust the exercise, the load or the number of repetitions.
Can physical therapy be done by telehealth?
Yes. Many therapists offer telehealth visits for assessment, exercise instruction and progress checks. It works well for many conditions, though some hands-on assessment may need in-person visits. Check coverage with your insurance.
What is the difference between a physical therapist and a physical therapist assistant?
Physical therapist assistants complete an associate degree and are licensed or certified in most states to provide treatment under the direction and supervision of a physical therapist. The physical therapist carries out the evaluation, sets and updates the plan of care, and decides when you are ready for discharge. You can ask who will be treating you at each visit.
What should I wear to physical therapy?
Wear comfortable clothing that lets you move freely and gives access to the area being treated, such as shorts for a knee problem or a loose top for a shoulder. Supportive athletic shoes are useful for exercise and balance work. Bring your insurance card, a list of medicines, any imaging reports and a note of your main goals.
Related topics
- Physical Therapy Services: Sorting the Evidence From the Noise (Rehabilitation)
- The Evidence on Talk Therapy, Without the Hype (Mental Health)
- Cardiac Rehabilitation: What the Evidence Actually Says (Heart Health)
- Psychological Therapies for Pain: What Published Guidance Supports (Chronic Pain)
Where to go next
- Starting Out With Physical Therapy
- The Short Guide to Physical Therapy
- Physical Therapy — the reference entry
- Back and Posture: The Complete Guide
- Low Back Pain: What Published Guidance Supports
- What the Guidance Really Says About Sciatica
When to speak to a doctor
Go to the emergency room rather than physical therapy for numbness around the genitals, buttocks or inner thighs, bladder or bowel changes, or weakness in both legs, and call 911 after a serious injury. See your doctor promptly for pain with fever, unexplained weight loss, a history of cancer, or progressive limb weakness.
Where this comes from
- American Physical Therapy Association — Direct Access by State
- National Institute of Arthritis and Musculoskeletal and Skin Diseases — Back Pain
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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