Get Physical Therapy First for Musculoskeletal Pain


"Direct access to physical therapy is more cost-effective in fewer visits than physician-first access in the United States, with greater functional improvement." (Hon 2020)



Musculoskeletal pain is typically not a medical problem. It is a consequence of lifestyle behaviors, programming variations, nervous system processing, and beliefs. There is no medicine that exists to heal musculoskeletal injuries or pain.


When someone has pain, they may go see their primary care physician, then a specialist. They can be prescribed pain medication, anti-inflammatory medication, or muscle relaxers. All of these pills work to mask the pain/injury and give a false sense of improvement.


In Maryland (and in all or most states), we have direct access to physical therapists. This means that you do not need to see a physician and receive a referral to go see a physical therapist. We are musculoskeletal specialists and movement experts (at least we all should be, but that’s a different discussion).


If you go see a physical therapist first, you are more likely to get an accurate diagnosis and you will have someone who spends time with you to figure out how exactly to manage your symptoms and set you on the path to reaching your goals. You will get out of pain faster and back to your favorite activities without wasting time and money on unnecessary procedures. We are also trained to know when something falls outside of our scope. Certainly, if you are not the right fit for physical therapy or if your injury is severe enough, we will recommend you to see a specialist and undergo imaging if necessary.


A recent article in the Physical Therapy Journal found that direct access to physical therapy resulted in significantly reduced costs associated with total healthcare expenses, physical therapy costs, and number of physical therapy visits. The physical therapy first model also resulted in significantly better functional outcomes.


Well, there you have it. It is cheaper to go to physical therapy first for musculoskeletal pain. It also leads to better and quicker outcomes. Don’t waste your time on costly and unnecessary tests. Go to physical therapy and start getting better.


Corey Hall, PT, DPT

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