How Physical Therapy Can Help Chronic Pain

David Reavy
by David Reavy
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How Physical Therapy Can Help Chronic Pain

I’ve been experiencing chronic low back pain, and my doctor recommended I try physical therapy. What do I need to know to get started?

First, know that it’s going to be OK. Physical therapy is not as scary as it sounds. When people think about physical therapy, they often think of it as a post-surgery or major injury necessity. It is often regarded as a sentence that needs to be carried out before people can return to the life they knew before injury or surgery.

But people often overlook the power of physical therapy (PT). It can:

  • transform your body
  • change the way you move
  • instill confidence
  • relieve pain

We broke down all you need to know about PT, and what you can expect when you start working with a physical therapist.

Who Are Physical Therapists?

People often view physical therapists, massage therapists, and athletic trainers are interchangeable. Yes, these professionals often work together to complement one another’s services, but it’s important to recognize that they are separate professions with their own specialties, education and licensing requirements.

Physical therapists are highly educated, licensed health care professionals. PTs must complete a three-year doctorate program and sit for a national licensure exam in order to practice. Bottom line, when it comes to the body and kinesiology, we know our stuff. You are in good hands.

But there is so much more to our profession than education and licensing. We are fiercely passionate individuals with a mission to help our patients. If you look at the American Physical Therapy Association’s mission and goals, you’ll find we work by, “transforming society by optimizing movement to improve the human experience.” That is what drives PTs. That is what gets me out of bed in the morning—the idea that I can transform the human experience of my patients.

What Do Physical Therapists Do?

Your doctor affirmed that you have low back pain, but what does that mean, exactly? Why do you have this chronic pain? As a physical therapist, my job is not only to help you relieve your back pain, but also to investigate what’s causing your pain. We are your body’s detectives.

Physical therapy is often paired with surgery, but many don’t realize the profound effect it can have on those suffering from chronic pain. About 80% of the population suffers from chronic low back pain (so you are not alone). Most people accept this pain as a permanent partner in life, and use shots and medications to get some temporarily relief. But physical therapists can offer more.

The main culprit behind chronic pain is an imbalanced body. The way most of us move—or don’t move—through the world, with excessive sitting and poor posture, causes muscles in your body to become too restricted and shut down. There are so many muscles that attach at the spine—your lats, quadratus lumborum, paraspinals, glutes and abdominals. If these muscles aren’t working the way they are supposed to, you will feel the effects in your spine.

Think about a car. If your car comes out of alignment, things start to fall apart, and your breaks and tires wear out faster. Unlike a car, you can’t easily change parts in your body. If your body is out of alignment, you will wear something down until it breaks.

By releasing the restrictions in the tight muscles and strengthening the weak ones, physical therapists provide mobility and stability, which in turn relieves chronic pain in a more permanent way.

While your main motivation to see a physical therapist is probably to relieve pain or recovery from an injury, you will find that another result will be more efficient movement. Increasing you mobility is addressing the cause of your pain or injury, and the result is relief of your symptoms. This is how we accomplish our mission.

How Do I Get Started?

By seeing your doctor, you’ve already taken the first step you need to see a physical therapist. In many states, a referral from a physician is required to be treated by a physical therapist. However, some states do have direct access, meaning physical therapists can evaluate and treat without the script. To find out what requirements your state has, check out this guide on the APTA website.

Once you’ve determined if you need a referral, the next step is to call the physical therapy clinic of your choice and set up an appointment. Clinics will often verify your insurance benefits before you start treatment. It’s important to have a clear understanding of what your insurance covers and any anticipated out-of-pocket costs before your first visit. While most insurance “covers” physical therapy, you might be limited to a certain number of visits per year, or need your insurance company to preauthorize any visits ahead of time. You might have a high deductible plan or copay, or be out of network with the PT you’ve chosen, which can all equal out-of-pocket costs for you. Again, make sure you go over your insurance benefits thoroughly so there are no surprises when you do get a bill.

What Can I Expect from Treatment?

Your first session is what we call an initial evaluation. It’s where you get to tell us what’s been going on. We’ll ask you questions and take measurements to get your baseline information, and then get to work on a plan. How many visits you need depends greatly on your diagnosis. After your first visit, your therapist will go over the details of your treatment plan and what goals he or she hopes to accomplish during therapy.

You’ll be re-evaluated periodically through the course of your treatment until you reach a point where you and your therapist agree you are ready to be discharged. In addition to your appointments, you’ll likely be given some homework, or what we call a Home Exercise Program (HEP). Completing a HEP is crucial to a timely recovery and, in many cases, should be continued even after you are done with treatment.

Where Can You Find Us?

Physical therapy is an incredibly diverse profession, with different specialties and work settings. I work in an outpatient clinic with a focus on orthopedics, but you can find physical therapists working in home health, schools, hospitals, fitness facilities, and even in work settings. To find a physical therapist best suited for you, I recommended going to APTA.org and utilizing their “Find a PT” tool. For example, if you are recovering from a sports-related injury or orthopedic surgery, look for someone who has specialties and certification that match that, such as an Orthopedic Certified Specialist (OCS) or Sports Certified Specialist (SCS). My personal recommendation would also be to look for someone who takes a whole body approach to physical therapy, and emphasizes the importance of manual techniques.

At the end of the day, physical therapy is all about changing what people think is possible when it comes to their bodies. It’s about shattering limiting expectations and giving people hope. It’s a profession I love profoundly and am proud to call my own.

About the Author

David Reavy
David Reavy

React_logoDavid Reavy is the founder and CEO of React Physical Therapy and creator of the Reavy Method. David’s own experiences with the limitations of traditional physical therapy inspired him to develop the Reavy Method, now recognized by the Illinois Physical Therapy Association as a continuing education course for physical therapists. The Reavy Method creates strength through balance using dynamic assessment, muscle release, and muscle activation. By balancing the body, the Reavy Method not only brings patients back to their previous level of function but also helps them become stronger than ever. David is a board certified clinical specialist in orthopedic physical therapy with credentials from the University of Illinois at Chicago. Past and current clients include Matt Forte, Tracy McGrady, and the many clients that come through React Physical Therapy in Chicago, IL every day. Follow React Physical Therapy on Twitter and Facebook.

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