In the case of an acute injury, PT within 30 days of the injury is associated with a lower likelihood of prolonged opioid therapy for pain. Among individuals who have never been on opioid medications, early PT is associated with reduced odds of any opioid use within a year of the injury. Among individuals with musculoskeletal pain who do use opioids, early PT is associated with a ~10% reduction in opioid dose.

Individuals seeking PT for pain generally agree that they would be willing to engage in discussions about potential opioid misuse with their physical therapist, and that physical therapists can place referrals to specialists to address opioid misuse; these views are similar for both individuals with and without a history of exposure to prescription opioids. This represents an opportunity for physical therapists to facilitate referral to other healthcare services to enhance opioid risk mitigation.

PT interventions (including exercise therapy) are frequently recommended by clinical practice guidelines for musculoskeletal pain conditions based on favorable evidence of effectiveness on pain intensity, pain-related function, pain prevention, and disability. These review articles examining PT effectiveness on pain outcomes often focus on specific types of pain, including low back pain, neck pain, osteoarthritis (especially knee osteoarthritis), and patellofemoral pain. One review evaluated the effectiveness of pelvic floor PT on chronic pelvic pain in women, finding positive effects on pain catastrophizing while acknowledging the complex nature of chronic pelvic pain and its different causes and relationships with pain.

Other review articles have studied combinations of interventions that include PT. For example, PT with pain education demonstrates effectiveness in reducing pain and improving functional outcomes in patients with chronic pain.

Studies investigating the effectiveness of psychologically-informed PT generally demonstrate a positive impact on self-management beliefs, provider capacity to deliver psychologically informed care, and overall disability. This finding is especially present when individuals are identified as having psychological contributors to disability, such as avoiding activities due to the fear of pain. However, there is also consistent evidence demonstrating that in pragmatic trials, these benefits are not observed. This discrepancy between the evidence observed in exploratory clinical trials and pragmatic trials is attributed to implementation barriers, including challenges with electronic health records that make interprofessional communication and referrals difficult, as well as the complexity of the intervention itself.

PT is a highly effective treatment for many common musculoskeletal conditions and offers significant economic benefits. A key report from the American Physical Therapy Association emphasizes that not only is PT clinically effective, but it also provides a positive net economic benefit. This means that the improvements in a patient's quality of life and the value of the outcomes exceeded the cost of the care they received. Moderate-to-good-quality evidence supports direct-access PT as a cost-effective intervention compared with a physician-first model in the United States, with greater functional improvement and fewer healthcare visits.