Physical Therapy

Physical therapy aims to reduce pain and improve physical function by enhancing strength, flexibility, and coordination.

Physical Therapy — Evidence Rating: Moderate to High Quality

Evidence for physical therapy comes from a robust body of literature, including numerous systematic reviews and meta-analyses, often citing moderate-to-high quality evidence for its effectiveness, particularly for musculoskeletal conditions like low back pain and knee osteoarthritis. This evidence is primarily drawn from many randomized controlled trials, with limitations in quality often related to lack of blinding of participants and providers (due to the nature of the intervention). Physical therapy is widely recommended in clinical practice guidelines, and its real-world implementation in health systems is often widespread with strong adoption. Future research opportunities include comparative effectiveness studies between different physical therapy approaches (alone and in combination with other interventions), testing innovative and collaborative care models involving PT, and designing novel implementation strategies to optimize PT success on patient and implementation outcomes.

Evidence-based Scale

Physical therapy (PT) aims to reduce pain and improve function by diagnosing, treating, and managing a broad range of conditions, including acute and chronic pain. PT frequently focuses on active care strategies, such as therapeutic exercise or functional training focused on strengthening the brain-to-body connection. Additional strategies may include “hands-on” manual/mobilization therapies (involving physical manipulation or manual contact using the hands); therapeutic ultrasound, electric stimulation, and other physiotherapy treatments; and the use of therapeutic devices (such as massage and traction devices) when appropriate for the pain-related condition. PT has evidence of reducing pain intensity and improving mobility, and for reducing pain medication use for acute and chronic musculoskeletal pain conditions, such as low back pain. This evidence base can vary based on the specific underlying condition.

Like other nonpharmacologic approaches, PT involves a comprehensive patient assessment, individualized treatment planning, and a holistic approach to overall health and well-being. PT often aims to address the underlying causes of pain through targeted exercises that address body mechanics and ergonomics, strengthen supporting structures, and restore proper movement patterns. Further, it empowers individuals with self-management strategies, enabling them to maintain their progress, reduce the likelihood of future injuries, and support overall function and well-being. A patient-centered, biopsychosocial approach can foster active participation in the recovery process, leading to improved functional outcomes and a higher quality of life.