WHEN TO SEE A PHYSICAL THERAPIST
WHEN TO SEE AN MD
WHAT TO EXPECT WITH IF YOU SEE AN MD

WHEN TO SEE A PHYSICAL THERAPIST

Physical therapy should be prescribed when you have been treated by your M.D. but pain persists beyond 1-2 weeks or if you have had multiple episodes of pain over the past year.
In most states you can go directly to a physical therapist. Depending on the nature of the condition, the therapist may refer you to a physician . The physician can prescribe medications, order tests and check to be sure you do not have a more serious medical condition that may be causing your symptoms.
Physical therapy treatments should address risk factors, prevention & a home exercise program in addition to pain reduction treatments. SELF CARE.
A physical therapy evaluation should include:
History( The therapists will ask: How did you hurt yourself, When did the pain first appear? What makes the pain worse/better? Have you had this type of pain before? What were you doing just before you felt pain? What does your daily routine involve? etc.)
Physical exam: ( You will be asked to do certain movements to determine what movements increase your pain, Your posture – how you sit & stand – will be evaluated, Your muscles will be palpated (massaged) to look for painful “knots” or spasm (increased tension), The mobility and quality of the motion of your joints will be checked, Your may have your reflexes tested, etc.
Physical therapy treatments will vary depending on the condition. A through treatment will include a few basic elements:
Pain reduction may include use of heat, ice, massage, relaxation, stretches, joint mobilization and other modalities including ultrasound & electric stimulation.
*A home program may start out as simple as a list of things to avoid. This should increase gradually as you progress to include exercises, stretches and some type of simple first aid. The goal is for you to gain control over the symptoms as you gradually eliminate the cause of the problem. * This is where physical therapy differs from traditional chiropractic care.
Prevention includes:
discussing risk factors for your specific condition.
exercises to increase strength and flexibility.
training in how to sit, stand, bend, move, return to sports, etc. without re-injuring yourself.
Suggestions for basic equipment including chairs, lumbar supports, wrist rests, etc. Depending on the person and the condition this may require purchasing a few items. Many “lumbar supports” can be made from simple items in the home such as pillows, towels, blankets. ( Your jacket can work as a lumbar support if you are out and you run into an unfriendly chair.)
Options are available such as physical therapy, acupuncture, orthopedic care, treatment by a chiropractor, physiatrist or neurologist and others including surgery for damaged disk, or a local injection (epidural).
Massage may help. Be sure the person is well trained or the massage may cause more harm than help.

When to see M.D.

If you fell and suspect you might have a fracture.
If you have severe pain.
If your pain does not response to home treatments.

WHAT TO EXPECT WITH IF YOU SEE AN MD:
Diagnostic Measures
Observe your symptoms. (What makes the pain worse/better)
Medical history and exam by a doctor & referral to a physical therapist for persistent symptoms.
EMG tests to determine if there is any nerve damage.
Testing is often not done unless the person is not responding to conservative treatment (rest, medications, physical therapy).
Treatment will depend on severity of the pain and discomfort. ACUTE vs. CHRONIC
ACUTE -sudden onset of pain or severe pain – pain after a fall on your arm – this may require an x-ray. Call your doctor. SELF CARE
CHRONIC- slow onset of pain (over months or years) or low grade pain (constant dull ache). This may be the first sign of RSI. Seek treatment if pain persists.
Appropriate Health Care
See your M.D. to determine the cause of pain. He/She may or may not take x/rays, schedule tests, prescribe medication or refer you to physical therapy.
Physical therapy treatment should address risk factors, prevention & a home exercise program in addition to pain reduction treatments.