Physical Therapy

What is physical therapy?

Physical therapy (PT) is a treatment program that helps you:

• build or regain strength
• improve mobility if you have a chronic illness, injury, or disability
• increase fitness through exercise
• learn about how to protect your joints, conserve your energy, and use assistive devices such as crutches, walkers, or grab bars
• perform daily living activities by helping you keep or improve your range of motion, strength, flexibility, coordination, balance, and endurance
• prevent injuries
• relieve pain.

When may physical therapy be needed?

Your healthcare provider may refer you to physical therapy when you do not have the strength or ability to do the things that you could do before you were sick or injured. PT helps to restore normal function or to keep you from getting weaker. For example, your provider may refer you to PT if you have:

• arthritis
• back problems
• broken bones
• osteoporosis
• stroke or other type of paralysis
• surgery such as hip or knee replacement
• problems with coordination or balance
• general weakness
• Parkinson's disease
• Alzheimer's disease.

What does a physical therapist do to help me?

The therapist will discuss a care plan with you. Your care plan may include frequent visits with the therapist for weeks or months until you have reached your treatment goals.

There are several types of treatments that a physical therapist may give you. The treatments you have will depend on your problem or condition. During your visits, your physical therapist may do the following:

• Physical treatments, such as:
  • deep heat (for example, using ultrasound)
  • cold packs and ice massage
  • whirlpools and water therapy
  • hot packs and paraffin baths
• Electrotherapeutic treatments, such as:
  • biofeedback (where you learn to control muscle or brain activity)
  • electrical muscle stimulation
  • transcutaneous electrical stimulation (TENS), which uses electrodes placed on your skin to stimulate the nerves and help block pain)
• Manual therapy, which is any "hands-on" treatment provided by the therapist, which may include:
  • massage
  • movements that help your joints and soft tissues
• Exercises: The therapist will probably teach you how to do exercises that will help you. You may learn how to use equipment for some of the exercises, such as stretchy resistance bands. You will start slowly and build up to what your body can handle.
• Mechanical traction, which uses a machine to mildly separate the joints of the spine and reduces spinal compression. Traction is most often used for people with neck or back pain.

Can physical therapy be painful?

The goal of physical therapy is to reduce your pain, but sometimes working to stretch and strengthen can cause minor aches and stiffness. Be sure to tell your therapist if you have any pain or discomfort during or after treatment.

How can I get physical therapy?

In most cases, a medical provider such as a doctor, physician's assistant, or nurse practitioner refer you to physical therapy. In some states, you may have direct access to physical therapy and not need a referral.

To find a physical therapist, call your local hospital, look in the Yellow Pages, or ask people you know for recommendations. To help select a physical therapist, ask:

• Are you a licensed physical therapist in my state?
• How much experience do you have treating people with my condition?
• Do you have specialized equipment, if needed, to treat my condition?
• Will you accept Medicare and what are your payment policies?

You can get PT as an outpatient of a hospital or skilled nursing facility, or from a home health agency, rehab agency, or public health agency. Or you may get services from the therapist in his or her office or in your home.

Physical therapy may continue on an ongoing basis as a home exercise program. You may be discharged from physical therapy with instructions to continue with your exercises at home.

What will my insurance or Medicare cover for physical therapy?

It's a good idea to check with your insurance company to learn what they will cover for physical therapy. Medicare helps pay for medically necessary outpatient physical therapy when:

• Your doctor or therapist sets up the plan of treatment.
• Your doctor periodically reviews the plan to see how long you will get therapy.

Medicare pays a percentage of PT bills that it approves. You are responsible for deductibles and parts of the bills not covered by Medicare. If you have a Medicare supplemental plan, the plan may cover these charges. The amounts you must pay may be higher if a physical therapist does not accept Medicare assignment.