Looking for Fall Prevention in Visalia? Part 2 is About Exercise

This is the second of our two-part posts about Fall Prevention in Visalia.

In our last blog, we provided a brief overview of why falls occur and offered some initial steps you can take to avoid them. Here, we take a closer look at what can happen after a fall occurs and focus on the importance of performing targeted exercises as you age.

A Significant Percentage of Falls are Very Serious

Although up to half of falls only cause minor injuries like cuts and bruises, research shows that about 20% result in far more serious injuries that often require a trip to the hospital. Fractures are undoubtedly the most severe complication that can come about from a fall. The hip is fractured more frequently than any other bone in older adults, and these injuries are particularly devastating because they significantly reduce mobility. As a result, many older adults are unable to regain their prior level of function and will require the assistance of a caretaker.

Some falls lead to head trauma and result in brain injuries as well, which can be extremely serious. Even falls from a low height can cause brain disturbances, and these injuries often go undetected. This is why it’s imperative that all older adults visit their doctor immediately if their head was involved in a fall in any way.

Fall Prevention in Visalia – Here’s Why

The good news is that most falls are preventable, and the better prepared you are, the lower your risk for falling will be. In addition to addressing environmental hazards within your home and taking appropriate precautions when leaving it, it’s also crucial to keep your body moving regularly and systematically.

The Proper Exercises Help…A Lot

Safely increasing your general physical activity levels is a great start, but performing specific exercises will be even more beneficial. As the body ages, it’s natural for strength, flexibility, and balance to start declining, which makes these areas the most important to address. For these reasons, we strongly recommend performing these 5 exercises to help you maintain your functionality and reduce your risk for falling in the process:

5 simple exercises to boost your balance

  1. Stand on one foot: hold a chair for balance, stand on one foot for 10 seconds, then repeat it with the other leg, 10-15 times each
  2. Back leg raises: same setup as #1, but instead of raising your foot, lift it back without bending your knees or pointing your toes, 10-15 times on each leg
  3. Side leg raises: same setup as #1, but lift your leg to the side while keeping your back straight and toes facing forward, 10-15 times with each leg
  4. Walk heel-to-toe: with your arms outstretched, focus on a distant point and walk in a straight line with your heel close to or touching your toe, for 20 steps
  5. Balance walk: use the same approach as #4, but take normal size steps and lift your back leg for one second before stepping, for 20 steps

According to a comprehensive review of studies published in December 2019, exercises that improve balance are best for reducing fall risk, with the results stating:

The updated Cochrane review is consistent with previous systematic reviews that identified greater falls prevention effects from exercise programs that challenge balance

If you’re new to these types of exercises, it’s best to consult with a physical therapist first to ensure you’re performing them safely and effectively, especially if your balance is impaired. Our physical therapists can also provide advice on how to become more physically active and guide you on how to eliminate hazards in your home, all with the overall goal of reducing your fall risk.

If You’d Like to Learn More About Our Balance & Fall Prevention Programs – Contact Us Today at 559-733-2478

Fall Prevention Program in Visalia Part 1 – Why It’s So Important

If you are in need of a fall prevention program in Visalia, we encourage you to read on.  We think this information may be of value to you and your loved ones.

Falls…A Silent Killer

Falls pose one of the greatest possible threats to the health of older adults. They are the leading cause of non-fatal injuries and death in this population, and as the number of older adults grows, so too will the incidence of falls and fall-related injuries.

Approximately one-third of older Americans—which those who are 65 and over—experience a fall each year, which results in more than 2.8 million injuries treated in emergency rooms.

Most fractures in this population are due to falls, with over 95% of hip fractures resulting from a fall of some sort. Other bones commonly fractured after a fall include the spine, forearm, leg and ankle, and the risk for these increases even more when osteoporosis—also common in older adults—is present.

Common Reasons Why People Fall

Falls can occur for a number of reasons, but they are often due to a combination of internal and external factors. After the age of 65, a variety of health conditions contribute to falls.  Some of them include:

  • Arthritis,
  • Dementia,
  • Diabetes,
  • Balance impairments,
  • Lower body weakness, and
  • Impaired vision or hearing

If you or a loved one has any of these or a combination of these risk factors, your risk of falling increases.

Don’t Forget Medications

Many older adults also take multiple medications, some of which can affect balance or otherwise interfere with one’s ability to stay on their feet.

Environmental Factors

Environmental factors also play a major role in fall risk. Failing to take proper precautions can leave a home filled with potential hazards that can be slipped or tripped on to cause a fall. These include:

  • Loose rugs,
  • Clutter,
  • Slippery surfaces,
  • Poor lighting,
  • Steep or uneven stairs, and
  • A lack of handrails or grab bars.

All of these are commonplace in homes if an older adults but these can be modified.

Do a home walkthrough to identify anything that could contribute to a fall
If a fall does occur, many people go on to develop a greater fear of falling, even if they’re not injured. This can cause them to limit their activities, which leads to reduced mobility and loss of physical fitness. Worst of all, this process can turn into a vicious cycle that further increases the risk for falling due to these changes. This shows why it’s so important to take the necessary precautions and reduce or eliminate potential hazards in your home. We recommend these tips to mitigate your fall risk:

  • Wear shoes with nonskid soles and consider using Velcro or spyrolaces
  • Walk through your home, take note of any obstacles that may lead to a fall, and make the necessary modifications to eliminate them
  • Install handrails on both sides of all stairways, avoid clutter and putting any items on the floor, remove throw rugs, and make sure your home is well-lit
  • In bathrooms, use non-skid mats, a raised toilet seat and grab bars as needed
  • Get your eyes checked once a year, and get adequate calcium and vitamin D
  • Take your time, be patient and ask others for help with difficult tasks
  • Stay physically active and avoid spending too much time sitting

The importance of regular physical activity for improving balance and reducing fall risk is continuously supported by medical literature, such as this recent study published in May 2019, which concludes with the following statement:

Regular physical activity including aerobic, anaerobic and proprioceptive components may be practiced in order to promote static balance in the elderly as a mean to reduce future risk of falling

Our Physical Therapists Can Help Reduce Fall Risks

Physical therapists can help you increase your physical activity levels in ways that are safe and feasible for you, which will lead to better overall health and a lower likelihood of falling. And read our next blog for additional tips to help you reduce your fall risk.

Contact Us Today at 559-733-2478 If You Would Like More Information

Hip Pain Specialist in Visalia

If you are looking for a hip pain specialist in Visalia, there are some natural treatments that you may know about.  In fact, physical therapy is your best bet for bothersome hip pain

There are several issues that can lead to hip pain and disability. Two conditions that are frequently responsible for this type of pain—especially in older women—are gluteal tendinitis and greater trochanteric bursitis. These two diagnoses describe separate problems, but they are so closely related that the terms are often used interchangeably.

Trochanteric Bursitis Versus Gluteal Tendinitis

Within your hip joint, like nearly every other joint in the body, there is a fluid-filled sac called a bursa. This structure provides a thin cushion that reduces friction between bones and other surfaces and allows a smooth, gliding motion of the joint. The bursa is located on the outside of the hip called the greater trochanter, and it can become damaged or inflamed for a number of reasons. This inflammation is called greater trochanteric bursitis, or greater trochanteric pain syndrome.

A similar condition involves the gluteal tendons, which are the tough fibers that connect the gluteal muscles in your buttocks to your hip bone. If one or more of these tendons are injured, the resulting condition is known as gluteal tendinitis, or gluteal tendinopathy.

Two Different Conditions with a Common Cause

Greater trochanteric bursitis and gluteal tendinitis both occur for similar reasons, with the most common cause being gradual damage from repeated activity that accumulates over time. Individuals who frequently use their hips in work or recreational activities are therefore more likely to overstrain their hips over time and experience these issues. Age is also a factor, as about 25% of women over the age of 50 are affected.

Symptoms of both conditions are also quite similar, with hip pain and tenderness being the hallmark signs in either case. This pain tends to be concentrated on the outside of the hip or thigh, and may often grow worse with activities like climbing stairs and when sleeping or lying down. Because these two conditions are so closely related and frequently occur together, in many cases either term is used to describe the same problem.

Physical therapy found to be superior compared to injections

Steroid injections are one of the more commonly used treatments for gluteal tendinitis/greater trochanteric bursitis, despite the fact that some studies have called their long-term use into question. Physical therapy represents another popular treatment option, and with this in mind, a study was conducted to compare the effectiveness of steroid injections, physical therapy, and a wait-and-see approach.

The results revealed that after both eight and 52 weeks, physical therapy led to greater improvements than the other two approaches.

This study provides further support of physical therapy as an effective intervention in the short and long term for gluteal tendinitis/greater trochanteric bursitis. Therefore, patients who are currently dealing with hip pain of any sort are strongly encouraged to consult with a physical therapist to identify the cause of your symptoms and begin a structured treatment program right away.

For More Information Contact Us Today at (559) 733-2478

We have two offices that have specialists that treat both trochanteric bursitis and gluteal tendinitis.  Click here for our contact information.


Patellar Tendinitis Treatment in Visalia

This post is for those that are looking for patellar tendinitis treatment in Visalia or Hanford.

Patellar tendinitis, which is often referred to as jumper’s knee, is a type of painful overuse injury to the tendon that connects the kneecap (patella) to the shinbone (tibia).

As the name implies, athletes in any sports that involve a significant amount of jumping—like basketball, volleyball, high jump, and soccer—are at an increased risk for developing jumper’s knee. All the jumping, landing, and changing direction that are part of these sports can strain or damage the patellar tendon, which is problematic.

Jumper’s Knee (Patellar Tendinitis) Comes from Excessive Stress

Too much stress on this tendon can create small tears, and over time, these tears can add up and eventually lead to symptoms. The most common symptoms of jumper’s knee are pain just below the kneecap, stiffness in the knee (especially while jumping, kneeling, or climbing stairs), pain in the thigh muscles (quadriceps) or weakness in the legs or calves. When this pain progresses, it will usually interfere with one’s ability to participate in sports or perform normal daily activities.

While some athletes might shrug off jumper’s knee and continue participating in sports, this strategy can be dangerous. Jumper’s knee is a serious injury, and pushing through the pain will only lead to larger tears and more pain, making the injury even more difficult to treat. Instead, one of the best choices you can make is to address your condition right away with a course of physical therapy. Physical therapists provide movement-based strategies that will alleviate your symptoms and improve your functional abilities. A typical treatment program for jumper’s knee will consist of the following:

  • Manual (hands-on) therapy techniques
  • Stretching exercises to reduce muscle spasms and increase flexibility
  • Strengthening exercises for your quadriceps and calves, which will build leg strength and help prevent further injury
  • Taping techniques to realign the patella
  • Education on how to best return to sports in a gradual and safe manner

The Benefits of Seeing a Physical Therapist that’s an Expert in Patellar Tendinitis Treatment

The benefits of physical therapy for jumper’s knee are frequently supported by medical literature. In one study published in 2016, which was the first of its kind, 29 jumping athletes with knee pain underwent two types of exercises (isotonic and isometric) that are often used in physical therapy. The conclusion states:

This is the first study to show a decrease in patellar tendon pain without a modification of training and competition load and the first study to investigate isometric exercises in a clinical setting.

Most patients who actively rehabilitate from jumper’s knee will eventually be able to return to their sport symptom-free, but the first step is seeking out help.  So, if you’re involved in a jumping sport or are experiencing any pain in your knees, we can get you started.

Call us today for more information or to schedule an appointment

Click here for the contact information from our two clinics.


Cubital Tunnel Syndrome Part 2

Confidently overcome your carpal tunnel syndrome
by changing how you use your hands and wrist

Most people use their hands throughout most of the day, especially for work-related tasks. But in some professions—like assembly line work and jobs that use vibrating hand tools—the repetitive motions involved can actually damage the wrist over time and lead to a painful condition called carpal tunnel syndrome (CTS). This is a condition caused by compression of a nerve in the wrist that leads to symptoms in the hand and wrist, but it can be managed by making some simple changes to the way movements are performed.

The carpal tunnel is a space at the base of the palm that contains several tendons and the median nerve, which provides sensation to the fingers. If these tendons thicken or any other swelling occurs in the area, this tunnel narrows, which puts pressure on the median nerve and leads to CTS. For this reason, CTS is considered a nerve compression syndrome, and it’s by far the most common type, affecting about 5% of the population.

Symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm. As CTS progresses, symptoms usually get worse when holding certain items, and hand weakness and numbness may occur more frequently if this pressure on the nerve continues.

The greatest risk factor for developing CTS is any task that requires repetitive hand motion, awkward hand positions, strong gripping, mechanical stress on the palms, or vibration. CTS can therefore occur in any line of work that involves one or more of these components. Office work and repetitive typing may be a potential cause, but the chances of developing CTS are three times higher in assembly line work like manufacturing and meatpacking. Other professions that have a high risk for CTS include sewing, baking, cleaning, sports like racquetball and handball, and playing string instruments like the violin.

Education and exercise to combat CTS

The best way to deal with CTS is to learn how to avoid movements that will make the compression worse, and then address the damage present with exercises and pain-relieving interventions. Our physical therapists recommend the following:

  • Education
    • Change your wrist positions and avoid bending your wrist for too long
    • Use proper neck and back posture, and avoid slouching
    • Keep your wrists straight when using tools and also while sleeping
    • Try to avoid flexing and extending your fingers and wrists repeatedly
    • Minimize repetitive, strong grasping with the wrist in a flexed position
    • Take frequent breaks to rest your hands and wrists
    • Modify your tools to make a more comfortable grip
    • Use anti-vibration gloves or wraps when using vibrating tools
  • Ice/heat to relieve pain
  • Strengthening exercises for the wrist, hand, and fingers
  • Stretching exercises for the wrist, hand, and fingers
  • A night splint to reduce discomfort

If you’re dealing with any hand or wrist symptoms that sound like CTS, it’s probably time to see a physical therapist for a structured treatment program that will target your impairments and teach you how to preserve your wrist from future issues.

Cubital Tunnel Syndrome and Other Nerve Compression Syndromes

Conditions resulting from pressure on nerves can be treated with specific exercises

The nervous system is the line of communication spans the entirety of the body and allows for all of its movements and functions to take place. But when a nerve is damaged and unable to transmit its message properly, it can lead to communication issues and a range of possible symptoms that can make movement more difficult.

This is the case with nerve compression syndromes, which is a group of disorders that occur when a nerve is squeezed or compacted by another structure in the area. Nerve compression syndromes involve the peripheral nerves—those outside of the brain and spinal cord—and are usually caused by repetitive movements that eventually impinge upon the nerve. There are several different types of nerve compression syndromes, with carpal tunnel syndrome being the most common, followed by cubital tunnel syndrome.

The cubital tunnel is located in the elbow and contains the ulnar nerve, which supplies sensation to the ring and little fingers. The ulnar nerve travels from the neck down to the hand, and it can be compressed—or pushed on—by other structures at any point along the way. But the most common place this occurs is behind the inside part of the elbow, where the cubital tunnel is located.

The result of this compression of the ulnar nerve is cubital tunnel syndrome. Symptoms typically include pain, numbness, tingling, and weakness in the arm and hand, which is particularly concentrated in the ring and little fingers. Cubital tunnel syndrome is also caused by daily habits like leaning on the elbow for long periods of time, sleeping with the arms bent, or from direct trauma to the ulnar nerve, like hitting your funny bone.

Other nerve compression syndromes include the following:

  • Cervical radiculopathy: results from compression of one of the nerve roots in the neck when it splits from the spinal cord; symptoms include a burning pain in the neck and down the arm, and weakness, numbness, and/or tingling in the fingers
  • Lumbar radiculopathy: occurs due to compression of a nerve root in the lower back when it branches away from the spinal cord; symptoms include pain, numbness, weakness, and/or tingling down the leg and sometimes into the foot
  • Piriformis syndrome: a rare condition occurring when a muscle in the buttocks (the piriformis) puts pressure on the sciatic nerve; the most common symptoms are tenderness in the buttocks and pain traveling down the thigh, calf, and foot
  • Other: Guyon’s canal syndrome, radial nerve compression syndrome, and thoracic outlet syndrome; symptoms typically include aches and pains, tingling or numbness, weakness, and reduced flexibility

Physical therapy and exercise can help reduce symptoms

If you begin to notice symptoms that suggest a nerve compression syndrome is present, physical therapy is often the best option available to manage your condition. A typical physical therapy treatment program may include bracing or splinting, modalities like ultrasound and electrical stimulation, and advice on how to make modifications to your lifestyle and posture. Another important component of treatment is exercise, particularly nerve gliding exercises, which help to maintain the health of nerves and restore their mobility if it has been lost. Below are four examples of nerve gliding exercises that can address cubital tunnel syndrome by targeting the ulnar nerve:

Physical therapists can provide you with a specific set of exercises for your condition and guide you to ensure you’re performing them correctly. They can also educate you on how to avoid certain movements that will further irritate your nerves in order to alleviate your symptoms.

Failing to access physical therapy could be contributing to the significant waste in the U.S. healthcare system

First, we’d like to take a minute to wish everyone a happy and blessed holiday season and thanks to all of our patient and community for the opportunity to serve you.  

Now, let’s talk about some of the major problems with our healthcare system…and Visalia and Hanford aren’t immune to this.

It’s a common talking point by now that the U.S. healthcare system is in need of repair, and one of the biggest issues is extremely high costs. In fact, we spend more on health care than any other nation in the world, with about 18% of our gross domestic product (GDP)—and approximately $10,000 per person—going directly to this system. But it’s also been found that significant portion of the money spent on health care is wasted, meaning that much can be saved if these areas are targeted.

Several studies have looked into these costs and how much can be considered “wasted spending,” but the most recent one was published in 2012. For this reason, researchers performed an updated review of the literature to estimate the levels of waste in the U.S. healthcare system, along with suggestions on how to reduce it.

Here’s What Some of the Research Says

To conduct the review, a search was performed for studies related to health care costs or savings over the past seven years. This process led to 71 estimates from 54 pieces of literature being included. Once collected, these documents were analyzed and calculations were executed to determine how much money was wasted on health care. Below are some of the key findings of the review:

  • The estimated total cost of waste in the healthcare system was $760 billion to $935 billion
  • Interventions to address this waste could potentially save $191 billion to $202 billion
  • These estimates account for about 25% of the total health care expenditures in the U.S.

The potential sources of waste were grouped into six categories, and suggested interventions were given to address each one (“failure of care delivery,” “failure of care coordination,” “overtreatment or low-value care,” “pricing failure,” “fraud and abuse,” and “administrative complexity.” Three of these categories apply specifically to wasted costs that may occur when patients do not undergo physical therapy for a painful condition:

  • Failure of care delivery: this is waste when the best types of practices to care for patients are not adopted or poorly executed
    • Example: an elderly patient could suffer a severe fall that could’ve been avoided if the patient was properly identified as at-risk and sent to a physical therapist to undergo a fall-prevention program
  • Pricing failure: costs of services that are significantly higher in the U.S. than other countries—for various reasons—contribute to this this type of waste
    • Example: a patient with shoulder pain that sees a primary care doctor may be sent to have an expensive MRI or CT scan right away, whereas with a physical therapist, treatment would likely begin without these tests
  • Overtreatment or low-value care: this type of waste results when patients receive treatments that are not considered effective according to research
    • Example: if a patient with low back pain visits a surgeon before seeing a physical therapist, surgery may be recommended to address their condition, even though research shows that it’s better to wait

The Healthcare System is More Patient-Centric than Ever – You Have Choices!

Patients have the power to lower their healthcare costs by educating themselves about their options.  By seeing a physical therapist first before any other medical professional, you can ensure that treatment will be started right away and most likely, you will be able to avoid unnecessary tests and treatments.  Click here to contact one of our offices.

Looking for a Knee Arthritis Expert in Visalia? Read This First

If you have knee pain and are looking for a knee arthritis expert in Visalia, this is important for you to read.

It’s a sad fact that health care is no longer about conservative care first.  It’s a power struggle.  The insurance companies are paying less and less and healthcare providers are struggling to stay afloat.  As such, they will provide aggressive treatment before conservative treatment.  It’s a shame.  The research proves this.  More patients with knee arthritis are being prescribed pain medications, while fewer are seeing a physical therapist.

Our position is simple:

You should try conservative, natural care first, that is easy to access, affordable, and has little to no side effects.  If, and only if you’ve given conservative care enough time (this is important because your body takes time to heal), and conservative care doesn’t work, then you should go to the next level care i.e. diagnostic tests, prescription drugs, injections, and maybe surgery.

Arthritis is one of those conditions that responds very well to conservative care.  Here we will discuss this in detail.

Osteoarthritis (OA), sometimes referred to as wear-and-tear arthritis, is a condition in which the natural cushioning between joints called cartilage gradually wears away. Over time, this causes the bones of these joints to rub more closely against one another because there is less shock-absorbing cartilage. Once this happens, individuals with OA will begin to experience symptoms like pain, stiffness, swelling, a feeling of warmth, and a decreased ability to move the joint normally.

OA is the Most Common Form of Arthritis

OA can occur in any joint in the body, but it’s most often seen in the hips and knees. Knee OA can also occur at any age, but the risk for developing it increases with older age because the body loses its ability to heal the damaged cartilage over time. This is why about 10% of men and 13% of women over the age of 60 have knee OA. Being obese or overweight also increases the chances of developing knee OA, since the additional weight puts more pressure on the knees and accelerates the process of cartilage thinning away.

There are a number of treatments available for addressing knee OA, but physical therapy and lifestyle changes—like losing weight and exercising more frequently—have consistently been recommended as first-line interventions that are supported by evidence. Following this course and seeing a physical therapist first can in turn lead to less use of healthcare and lower costs, as it will help patients avoid surgery and other expensive treatments. But many patients with knee OA go to a primary care doctor or surgeon to be evaluated first, leaving it up to them to decide whether or not to refer the patient to physical therapy. Some doctors will prescribe pain medications—like opioids— instead, which is not recommended as a long-term solution for knee OA.

Some Doctors Aren’t Trying Conservative Care First

To get a better idea of the decisions doctors make when treating knee OA patients, a study was conducted to evaluate the referral rates for physical therapy and lifestyle changes compared to prescriptions for pain medications. After searching through medical records, researchers identified 2,297 visits related to knee OA in which patients saw a surgeon, primary care doctor, or some other specialist. Analysis of these records over an eight-year period led to the following key findings:

  • Physical therapy and lifestyle changes were not frequently recommended, and there was a trend towards fewer referrals to physical therapy and lifestyle suggestions from surgeons over this time period
  • The rate of prescriptions for non-steroidal anti-inflammatory drugs (like ibuprofen) nearly doubled in visits to both primary care doctors and surgeons
  • Prescriptions for opioids increased by nearly three-fold over this period of time, even though opioids are generally not recommended for knee OA

This study shows that despite many clear guidelines that push for non-drug and non-surgical treatments such as physical therapy for knee OA, the developing pattern is going in the opposite direction, as many doctors are not following these recommendations. One solution is for patients with knee OA to take matters into their own hands and see a physical therapist first rather than a specialist or primary care doctor. Patients do not need a referral for physical therapy and can make an appointment for their first visit on their own.

So, if you are searching for a knee arthritis expert in Visalia, and if you have questions, make sure you contact us for more information.  Simply click here.  We have two, convenient locations.

Physical Therapy First to Avoid Opioids


The opioid epidemic continues to ravage the U.S. In 2015, more than 12 million Americans reported long-term use or misuse of opioids, and there were over 42,000 deaths related to opioids in the following year. These statistics—which have largely been driven by an ongoing trend of over-prescribing pain medications—are just a brief glimpse into this multifaceted issue and the toll it’s been taking on the country.

Low back pain (LBP) is one of the most prevalent health conditions that American seek out medical care for, as up to 80% of the population will experience it at least once at some point in their lives. Several studies have shown that LBP is also among the most common conditions for which opioids are prescribed, and more than half of individuals who use opioid report a history of back pain.

This is all in spite of the fact that most guidelines recommend that opioids are not used for LBP unless other recommended treatments have failed and it’s likely that the expected benefits of opioids will outweigh the risks. Instead, these guidelines recommend that patients with LBP try other non-drug treatments first, which includes physical therapy, exercise, and other similar interventions.

Physical therapy is a movement-based strategy that addresses painful issues like LBP with a variety of exercises and techniques designed to alleviate symptoms and help patients move more easily. The primary advantage of physical therapy is that it identifies the root of the problem and helps patients learn to overcome it with specific movements, while pain medications like opioids are only intended to be a short-term solution that simulates pain relief. Physical therapy is also regarded as an extremely safe intervention with minimal to no risk for side effects.

Why physical therapy is recommended first, as outlined by a recent study

Patients with LBP have several options when it comes to deciding what type of medical professional to see for their condition, and it’s possible that who they see may affect the likelihood of receiving an opioid prescription in the future. With this in mind, a study was conducted to evaluate whether there is a connection between the medical professional these patients see and their eventual use of opioids. Below is a summary of the results:

  • Over five years, there were 126,504 patient visits for LBP
    • More than half of patients (53%) initially saw a primary care doctor, while only 1.6% initially saw a physical therapis
  • About 18% of patients received an opioid prescription within 3 days of the initial visit, 22% received one within 30 days, and 1.2% used them in the long term
  • Patients who saw a chiropractor, acupuncturist, or physical therapist first all had significantly decreased odds of both early and long-term opioid use compared to those who saw a primary care doctor first
    • Patients who visited a physical therapist first had a 85% decreased chance of using opioids early after their visit compared to a primary care doctor

These findings show that it really does make a difference what type of medical professional you see first for LBP, and this applies to other conditions as well. Patients in pain are therefore encouraged to see a physical therapist before anyone else in order to begin an effective treatment plan that will lead to improvements while avoiding the risk of being prescribed opioids.

Direct Access Over Physician Referral

Before aggressive treatment with potentially harmful side effects, here’s why you should consider physical therapy

If you hurt yourself or start noticing any sort of pain, there are many decisions you’ll have to make next. Do you avoid physical activity or movements that might aggravate the pain? Do you put ice or heat on it, or take any medications to reduce your pain level? If the pain doesn’t improve after a certain period of time, do you see a professional for treatment? And if you do decide to see someone, who will it be?

It may be difficult to find the best answers to these questions, especially the last one about who to see first for  treatment. As a result, many people will end up scheduling an appointment with their primary care doctor, since it probably seems like the safest and most familiar choice when something is wrong. While primary care doctors are expected to always provide patients with the best possible treatments, it doesn’t guarantee you’ll receive treatment from a physical therapist.

Physical therapists are movement experts that are trained to optimize patients’ quality of life through carefully designed exercise and educational treatment programs. They treat a wide variety of injuries and conditions, but the most common symptom that they address is pain, and research consistently shows that physical therapy is effective for reducing it.

This is why most guidelines recommend that anyone in pain sees a physical therapist as a first-line treatment for their condition. Patients can either go straight to a physical therapist because of direct access—which allows anyone to at least have an initial consultation without a referral in all 50 states—or they can go their primary care doctor or some other medical professional and possibly get referred to therapy. Primary care doctors are strongly encouraged to direct patients with painful conditions involving the muscles and bones to physical therapy, but this does not always occur as it should.

Study highlights a major issue with the referral system for physical therapy

One of the many conditions that can benefit from physical therapy is knee osteoarthritis (OA), which has doubled in prevalence in recent years (at least 15 million Americans currently have it). As with other issues, many patients with knee OA visit their primary care doctor first, which may or may not lead to a physical therapy referral. To evaluate how many patients with knee OA are actually being referred and what other treatments patients receive, a study was conducted. Below are some highlights from its results:

  • There were 2,297 visits with a primary care doctor, surgeon, or another specialist
  • There was a significant decline in the number of referrals to physical therapy from orthopedic specialists over three years
  • The number of primary care doctors that referred patients to physical therapy was low and did not change in any significant way over three years
  • There was a non-significant increase in narcotics prescriptions and a significant increase in the number of non-steroidal anti-inflammatory drug prescriptions

This study shows that many doctors are not referring patients to physical therapy, and that the trend is actually going in the wrong direction, with an increase in pain medication prescriptions and a decrease in therapy referrals. That’s why the best way for patients in pain to avoid the risk of not getting referred is by taking matters into their own hands and accessing physical therapy directly.