Physical Therapy: A Proven Path to Resolving Musculoskeletal Pain

Musculoskeletal pain is one of the leading causes of disability and reduced quality of life globally. From chronic back pain and joint dysfunction to post-surgical rehabilitation and acute injuries, musculoskeletal conditions touch people of all ages. Amid rising healthcare costs and a growing demand for conservative, non-invasive treatment options, physical therapy has emerged as a cornerstone of effective musculoskeletal care. Backed by rigorous education, clinical training, and a growing body of research, physical therapists are uniquely positioned to assess, diagnose, and treat a wide range of musculoskeletal conditions — often faster, more effectively, and more affordably than other care pathways.

The Educational and Clinical Foundation of Physical Therapists

Physical therapists are highly trained movement specialists. In the United States, all newly licensed physical therapists must graduate from an accredited Doctor of Physical Therapy (DPT) program — a rigorous three-year graduate degree that follows a bachelor’s education. These programs include intensive coursework in anatomy, biomechanics, neuroscience, physiology, pathology, and evidence-based practice. Just as importantly, DPT students’ complete months of supervised clinical education in a variety of settings, including orthopedic outpatient clinics, hospitals, and rehabilitation centers.

After graduation, PTs must pass the National Physical Therapy Examination (NPTE) and meet state licensure requirements. Many go on to complete post-professional residencies or board certifications in orthopedic, sports, geriatric, or neurologic physical therapy. According to the American Board of Physical Therapy Specialties (ABPTS), over 30,000 physical therapists have achieved board certification, indicating advanced clinical knowledge and skills.

This foundation in movement science, hands-on assessment, and clinical reasoning makes physical therapists well equipped to be frontline providers for musculoskeletal conditions.

Research Supporting the Effectiveness of Physical Therapy

A growing body of evidence confirms that physical therapy is both clinically effective and cost-efficient for a wide range of musculoskeletal issues. When patients access physical therapy early, they often experience faster recovery, lower healthcare costs, and reduced likelihood of unnecessary imaging, injections, or surgery. 1-4

Low Back Pain: A Case Study in Physical Therapy’s Value

Low back pain is the most common musculoskeletal complaint, and the leading cause of years lived with disability worldwide. Physical therapists have demonstrated exceptional outcomes in managing both acute and chronic low back pain.

A 2018 study published in Health Services Research found that patients who received physical therapy early for low back pain had significantly lower total healthcare costs compared to those who received delayed or no PT care.2 So why is that? This study highlighted that those patients who sought PT first had an almost 90% reduction in use of opioids, a 28% reduction in imaging, and a 15% reduction in emergency room visits.

While minimizing cost and care are both important metrics to consider, it’s worth highlighting the huge reduction in opioid medication use. As we’ve discussed in prior blogs, the opioid crisis has ravaged the US, leaving families and communities in shambles.

PT’s ability to intervene quickly to improve symptoms is a highly effective tool at combating the opioid crisis. This was further confirmed in a 2020 meta-analysis in JAMA Network Open, which revealed that early physical therapy intervention significantly reduced the odds of subsequent opioid use in patients with musculoskeletal pain.4

Avoiding Unnecessary Procedures

A common pattern in musculoskeletal care involves a progression from primary care to imaging, to medication, to injections, and finally to surgery — often with marginal benefit and significant cost. Physical therapy interrupts this cycle. For example, research in Spine showed that patients who consulted a physical therapist early after a new primary care visit for back pain had a decreased risk of advanced imaging, additional physician visits, surgery, and opioid use.1

Moreover, studies have demonstrated that physical therapy can be just as effective as surgical intervention. Take meniscal tears of the knee as an example. Several studies,5-6 both of which were systematic reviews, outline that physical therapy is the preferred approach for managing this clinical finding. Not only does therapy have fewer potential complications, it’s also significantly cheaper.

Patient Empowerment and Long-Term Benefits

Beyond symptom relief, physical therapists emphasize self-management and long-term wellness. Treatment plans often include tailored exercise programs, ergonomic modifications, and strategies to prevent recurrence. This empowers patients to take control of their health and reduces dependency on passive treatments like medications or injections. Furthermore, physical therapists’ emphasis on patient education has been shown to be effective at improving symptoms and quality of life following an injury, and even in cases of chronic pain.8-9

One study highlighted that “utilizing pain education strategies in conjunction with interventions provided by physical therapists demonstrates a moderate to large effect sizes on pain and disability constructs.8”

Physical Therapy and Worker’s Compensation

Worker’s compensation systems universally struggle with the nuance of navigating patient concerns with timely access-to care, cost of treatment, and duration of a claim. Many interventions available to injured workers can be invasive or expensive, requiring authorization and a risk/reward consideration from all stakeholders.

Yet, physical therapy, with its short and long-term benefits, stands ready and easily available to most injured workers. As mentioned above, physical therapists are musculoskeletal experts who can intervene in skilled ways to improve pain, enhance function, and ultimately promote self-reliance as an injured worker is returned to full-duty. In a system that is focused on outcomes, cost, and case duration, physical therapy should be top of mind for physicians, payors, and employers alike.

Conclusion

Musculoskeletal conditions are among the most common — and costly — health issues worldwide. Physical therapists offer a proven, science-based, and patient-centered solution. With extensive education, clinical expertise, and a growing body of supportive research, PTs manage and resolve musculoskeletal pain effectively, safely, and efficiently.

For patients seeking to avoid unnecessary imaging, drugs, or surgery — and for healthcare systems seeking to contain costs — physical therapy is not just an alternative. It’s often the best first choice.

To learn more about how Upstream Rehabilitation and our family of brands can assist with Workers’ Compensation and how physical therapy plays an effective role in helping injured workers return to work, contact our Workers’ Compensation team today!

 

References:

  1. Fritz, J. M., Childs, J. D., Wainner, R. S., & Flynn, T. W. (2012). Primary care referral of patients with low back pain to physical therapy: Impact on future health care utilization and costs. Spine, 37(25), 2114–2121. https://doi.org/10.1097/BRS.0b013e3182452d23
  2. Frogner, B.K., Harwood, K., Andrilla, C.H.A., Schwartz, M. and Pines, J.M. (2018), Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health Serv Res, 53: 4629-4646. https://doi.org/10.1111/1475-6773.12984
  3. Pendergast, J., King, P., Sands, L., & Amos, K. (2012). The effect of direct access to physical therapy in a managed care organization. Health Services Research, 47(2), 1342–1360. https://doi.org/10.1111/j.1475-6773.2011.01320.x
  4. Sun, E., Moshfegh, J., Rishel, C. A., Cook, C. E., & Brophy, R. H. (2020). Association of early physical therapy with long-term opioid use among patients with musculoskeletal pain. JAMA Network Open, 3(8), e2011423. https://doi.org/10.1001/jamanetworkopen.2020.11423
  5. Hohmann, E., Hohmann, E., Hohmann, E., Glatt, V., Tetsworth, K., & Cote, M. P. (2018). Arthroscopic Partial Meniscectomy Versus Physical Therapy for Degenerative Meniscus Lesions: How Robust Is the Current Evidence? A Critical Systematic Review and Qualitative Synthesis. Arthroscopy, 34(9), 2699–2708. https://doi.org/10.1016/J.ARTHRO.2018.04.018
  6. Moin Khan, Nathan Evaniew, Asheesh Bedi, Olufemi R. Ayeni and Mohit Bhandari. Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis CMAJ October 07, 2014 186 (14) 1057-1064; DOI: https://doi.org/10.1503/cmaj.140433
  7. Li Y, Yan L, Hou L, et al. Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Front Public Health, 16 November 2023 Sec. Aging and Public Health Volume 11 – 2023 | https://doi.org/10.3389/fpubh.2023.1155225
  8. Marris D, Theophanous K, Cabezon P, Dunlap Z, Donaldson M. The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials. Physiother Theory Pract. 2021 Apr;37(4):461-472. doi: 10.1080/09593985.2019.1633714
  9. Lane E, Magel JS, Thackeray A, Greene T, Fino NF, Puentedura EJ, Louw A, Maddox D, Fritz JM. Effectiveness of training physical therapists in pain neuroscience education for patients with chronic spine pain: a cluster-randomized trial. Pain. 2022 May 1;163(5):852-860. doi: 10.1097/j.pain.0000000000002436. PMID: 34354017; PMCID: PMC8816964.
  10. World Health Organization. “Musculoskeletal Health.” World Health Organization, 14 July 2022, www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions.
  11. “Employer View of Specialist Certification.” APTA Specialist Certification – Governed by ABPTS, specialization.apta.org/for-specialists/marketing/employers.
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