Starting Out With Physical Therapy

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.

Why bother

In every state you can see a physical therapist without a referral in at least some circumstances, which most people do not know.

Start here

Two things, and nothing else until both feel routine.

• Check your state rules and your insurance before booking directly
• Do the home exercise program, which is where the effect comes from

Then add these

After that, these.

• Ask what the exercises are for and how to progress them
• Say early if something is not working so it can be changed

The numbers, in one place

Common early mistakes

• Expecting passive treatment alone to resolve the problem
• Stopping exercises as soon as pain settles
• Assuming you always need a doctor's referral first

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

• Physical Therapy: Common Questions Answered
• 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.