The short answer: when a movement problem has stopped improving on its own, when it is changing what you do, or when you have an injury or surgery that needs a structured recovery. You do not need to be in severe pain to benefit, and you do not need to wait until something has become chronic.
Signs it is time for an evaluation
- Pain that has lasted more than two weeks without clear improvement
- A problem that keeps returning to the same area every few months
- Stiffness or weakness that has changed how you work, exercise, or sleep
- An injury where you are unsure what is safe to do
- A scheduled or recent surgery involving a joint, tendon, or the spine
- Feeling unsteady, or having had a fall or near-fall
- Being told to strengthen an area without being shown how to progress it
When to see a physician first
Physical therapy is not the right first stop for everything. Seek medical evaluation before starting therapy if you have any of the following.
- Inability to bear weight or use a limb after an injury
- Obvious deformity, or a joint that dislocated
- Loss of bladder or bowel control, or numbness in the saddle region
- Progressive weakness or numbness in an arm or leg
- Fever with a hot, swollen joint
- Unexplained weight loss, or severe night pain unrelated to position
- Chest pain, shortness of breath, or symptoms suggesting a stroke — call emergency services
What waiting actually costs
Two things tend to happen while a problem is left alone. The tissue deconditions, so there is more to rebuild later. And movement patterns change to avoid the painful area, which loads neighboring joints in ways that generate secondary problems. Neither is irreversible, but both add time to the eventual recovery.
What an evaluation involves
- 01A conversation about how the problem started, what makes it better and worse, and what you need to get back to
- 02Screening for findings that would warrant referral to a physician
- 03Objective measurement — range of motion, strength, and relevant functional tests
- 04Movement assessment of the tasks that bother you
- 05A plan of care with expected visit frequency, goals, and how progress will be measured
A note on referrals
Access rules for physical therapy vary by state, and insurance plans often have their own referral and authorization requirements that are separate from state law. Confirm both your state's current rules and your specific plan's requirements before assuming a referral is or is not needed.
This article is general educational information and is not a substitute for an individual evaluation. Before publication under a clinic's name, it should be reviewed and attributed to a licensed physical therapist on staff.