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What is Direct Access and Why You Should Take Advantage

Direct access means that you are able to go see a physical therapist with NO doctor referral or visit required. I'll say that again for the people in the back. In Massachusetts, you do NOT need to go see a doctor before beginning PT or getting an evaluation from a PT. This is a little known fact that most people don't take advantage of.

When someone has pain, the first thing they usually think of is: "I should go see the doctor to find out what's wrong". The problem with this is that your primary care doctor is not a movement specialist and is not well equipped to treat your aches and pains. They will usually order expensive imagining and other tests before eventually deciding to refer you to a physical therapist for further evaluation. Typically, an MRI will cost around $2,700. So now you've spent all this extra time and money before still getting sent to physical therapy to find what's causing your pain. If this system seems a little backwards to you, you're on the right track.

Instead of going to your doctor first and extending the recovery process with expensive and often-times unnecessary imaging, come see your PT directly. As Doctorates of Physical Therapy, we are trained to catch any unusual or abnormal findings that warrant a closer look from another doctor. This means that you will only get imaging if we believe something weird is going on instead of having that be the first line of defense. That being said, most pain can be resolved regardless of what shows up on the imaging anyway. This is an important concept that many doctors do not even realize.

Recent studies show that almost 80% of people through all age groups have degenerative changes such as disc herniations, arthritis, and all kinds of other scary sounding stuff. Interestingly enough, they found that the majority of these people were still asymptomatic, meaning they weren't in pain. These types of changes also don't typically happen over night, meaning they'd had them for quite some time. If these changes have been there the whole time it doesn't make sense that all of a sudden they are causing the pain you're experiencing. This shows that pain doesn't correlate well with structure. All that the imaging is doing is putting "thought viruses" in your head, making you think about how scary your "diagnosis" is and now worrying about blowing your back out with every movement.

Another study looked at the effects imaging had on patient's overall outcome when combined with physical therapy. The study was broken into three groups: one that got manual therapy and exercises, one that got manual therapy, exercises, and education, and one that got manual therapy, exercises, and imaging. After what you've learned from this article, I'm sure you can guess which group had the worst outcomes. That's right, the group that had imaging. The group who received exercises and education ended up with the best overall outcomes. What does this mean for you? It's even more important for you to take advantage of direct access if you want to end up with the best and quickest results.

Instead of a diagnosis, I prefer a solution to your pain. Finding what positions/movements relieve your pain and educating you that you're not going to "blow out" your back are the keys to regaining control of your life. If you'd like to learn more about our approach and if we're right for you, give us a call.

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