Suppose you finally decided to see your doctor about some chronic pain in your knee, shoulder, or back. Your doctor prescribed you PT, but you’re skeptical. Does physical therapy really work? Is it worth the weeks of follow-up care?
As a physical therapist myself, of course I’m biased to say that physical therapy does really work. But the benefits of PT are as real as the objections you may feel right now. Consider this article my expert rebuttal to a reluctance for rehab, based on my firsthand experience and the research of the medical community.
Is Physical Therapy Going to Help Me?
When someone is apprehensive about going through with physical therapy, it’s usually for a handful of reasons. First, there’s the fear of the unknown, if you’ve never done PT before. You’re already dealing with pain—won’t PT make it worse? And there’s the financial side of things: not all insurance plans cover PT visits, and the multiple-visit nature of therapy can make costs really accumulate.
Finally, many patients avoid PT because they doubt it will work. Why spend all this money, effort and potential discomfort on something that won’t put you in a better place than you were when you began?
But your doctor is right to prescribe physical therapy—it does really work. I can verify that, based on the cost-value of physical therapy and the real results it brings, pursuing PT for your chronic pain is absolutely worthwhile.
How Physical Therapy Can Help
After working in physical therapy for the better part of a decade, I could give countless examples of how PT has helped my patients see positive outcomes, from preventing falls and overuse injuries to recovering from injury or surgery. But for the sake of this post, I’ll focus on just five conditions we often see in the clinic, detailing how each one is treated and what the research says about the effectiveness of PT.
Neck Pain (Cervical Radiculopathy)
Also called a pinched nerve, cervical radiculopathy is an inflammatory condition that produces numbness, tingling, and sharp pain. You may also experience regular headaches and radiating pain down your arms or into your chest.
While you could pop painkillers until the discomfort goes away, a more long-term solution lies in physical therapy, which will address your symptoms as well as the root cause of the compression in your neck.
Common PT treatments for cervical radiculopathy include the following:
- Manual therapy, such as soft-tissue mobilization
- Cervical traction
- Strengthening exercises for muscles in your neck, back, and chest
- Stretching and flexibility training for the neck, upper back, and shoulders
Research
Physical therapy is broadly evidence-based, meaning the treatments your PT suggests are backed by the latest findings in medical research. And the common treatments for cervical radiculopathy are no different. In this systematic review, exercise—either alone or taken with other treatments—effectively improved quality of life, decreased pain, and increased functioning in patients with neck pain. When combined with therapeutic exercise, manual therapy, including the soft-tissue mobilization that a PT is trained to perform, has also evidently produced long-term benefits on a patient’s neck pain, mobility, and strength.
Shoulder Pain
In the PT clinic we see all kinds of shoulder injuries. The most common include rotator cuff tendinopathy (tendonitis), bursitis or shoulder impingement, and rotator cuff tears. By leaving any of these issues unaddressed, you could exacerbate severe pain and debilitation in an area of your body you use for practically everything.
Physical therapy for shoulder injuries consists of some of the following interventions:
- Therapeutic exercise, including resistance band exercises
- Eccentric exercise, or movements that strengthen the muscle as it lengthens instead of as it contracts
- Strength training in the rotator cuff and scapular muscles
- Stretching and joint mobilization
To help treat shoulder pain, your PT may suggest supplementing these exercises with other modalities such as laser therapy, electromagnetic nerve stimulation or TENS, and cryotherapy.
Research
In this controlled trial, patients with bursitis or shoulder impingement benefited best from physical therapy treatment that included exercise, joint mobilization, and laser therapy. Similar evidence exists for rotator cuff tendinopathy; when dosed appropriately under the guidance of a PT, eccentric exercises for the scapular muscles and rotator cuff muscles can reduce pain and improve shoulder function. And for patients with rotator cuff tears, physical therapy has proven to be a successful non-surgical treatment. In fact, 75% of the patients in this study benefited enough from PT to not need surgery on their full-thickness rotator cuff tear.
Low Back Pain (Lumbar Radiculopathy)
About 40% of American adults have back pain, and it’s the leading cause of missing work. If you’re part of that statistic, you know how debilitating and discouraging back pain can be.
Low back pain usually refers to pain in the region of your spine below your lowest ribs. This pain may be shooting, throbbing, or radiating down a leg. When low back pain results from a pinched sciatic nerve, it may indicate a condition called lumbar radiculopathy.
Physical therapists treat lumbar radiculopathy with some of the following techniques:
- Therapeutic aerobic exercise, such as walking and cycling
- Resistance and strength training for the glutes, hips, and hamstrings
- Activation of trunk muscles and trunk mobility
- Stretching, massage and soft-tissue mobilization
Research
Across multiple studies, research shows that physical therapy treatments produce better outcomes for patients with low back pain than do other types of treatments. In this case report, researchers found that the manual therapy and stabilization exercises performed in PT can effectively reduce back pain. And putting it off only makes it worse: An early start to physical therapy leads to more robust outcomes at the 4-week, 6-month, and 1-year mark than waiting a few weeks to start treatment.
Knee Arthritis
Pain and stiffness in the knee may indicate arthritis, of which there are dozens of varieties. But osteoarthritis (a degeneration of the cartilage in the joint) and rheumatoid arthritis (a swelling of the synovial membrane in the knee) are the two most widespread. Although both are genetic and difficult to prevent, you can manage the symptoms of pain and swelling. Opioids is one common—and controversial—solution, but pharmacological intervention isn’t the only way to treat arthritis.
To treat knee arthritis the physical therapy way, you would undergo some of the following interventions:
- Therapeutic aerobic exercise, such as walking and cycling
- Resistance and strength training for the quads, hips, and hamstrings
- Balance training
- Stretching, massage and soft-tissue mobilization
Research
Even arthritis can’t stand up to the real results physical therapy can bring. In this study, patients with knee osteoarthritis who received therapy (consisting of manual therapy and a standard knee exercise program) scored better on their knee function, pain and stiffness than their placebo counterparts at the 4-week, 8-week, and 1-year mark. Just because arthritis is incurable doesn’t mean intervention is worthless. Physical therapy can give you the tools you need to improve your quality of life and stay strong despite the disease.
Achilles Tendonitis
Another affliction we see often in the PT clinic is heel pain. If the pain is in the bottom of the heel, it may be plantar fasciitis; if it’s the back of the heel, achilles tendonitis is the likely culprit. The painful inflammation of achilles tendonitis typically arises from overuse, especially in athletes.
When I see heel pain in the clinic, I use the following physical therapy strategies to help my patient find long-term relief:
- Stretching of the soleus, gastrocnemius, and hamstring muscles
- Strengthening exercises such as heel lifts
- Eccentric exercises, or movements that strengthen the muscle as it lengthens as opposed to as it contracts
- The wearing of night splints and orthotics
Research
Achilles pain can be difficult to treat, but research shows that physical therapy—specifically eccentric exercise—can provide some of the most positive results. In this study, patients with mid-calf achilles tendonitis were given 12 weeks of eccentric exercises as part of a physical therapy regimen. Compared to patients who relied only on splints, the patients with physical therapy reported less pain and better functioning even up to a year after the study began.
What About the Cost of Physical Therapy?
Alright, you may concede: perhaps physical therapy really does work. But what about the costs? Is it really as valuable as its price?
First, consider how much it costs to not go through with your PT. How much are you paying for alternative remedies? Those can range from years of medication (and the side effects they often engender) to the cost of surgery and the rehab it will require.
Then think about the value PT can bring to your life. Can you put a price on less pain, better mobility, and even a longer life expectancy? If PT really does work—which the research says it does—then the value of these benefits is also on the table.
While such thought experiments may feel abstract and inexact, the American Physical Therapy Association actually crunched the numbers and came up with the value of PT for several common conditions. In their report, The Economic Value of PT in the US, they found that physical therapy for low back pain is worth $4,160 over its costs. Similarly, treating knee osteoarthritis with physical therapy brings, on average, a net value of $13,981 in avoided costs and improved quality of life.
So if your objection to PT is down to costs, I’d argue you can’t afford not to do physical therapy!
Verdict: Does Physical Therapy Really Work?
From head to toe—neck pain to heel pain—physical therapy can improve patient outcomes and produce long-lasting benefits that outweigh their costs. Although pharmacological treatment and multimodal treatments can offer some relief, there’s nothing like therapeutic exercise and stretching for helping reset and restore the body. Physical therapy does work, and it helps millions of people every year.
Can you do physical therapy on your own? Possibly. But PTs have worked with countless other people who are suffering from what you are too. We’re movement experts who can coach you through each therapy, administer special modalities in the clinic, and ensure you have the appropriate dosing for each treatment. Ultimately, following the professional guidance of a PT will help you find relief fast and get you back to doing what you love, be it walking, working outside, playing sports, or living independently.
When you’re ready to get started, check out this post about how to find a good PT clinic.
