I recently read an article in this newspaper by David Bertone, a physical therapist, about obtaining an annual “physical therapist checkup.”
He unfortunately made a false statement that “your primary care physician isn’t specifically trained to assess your musculoskeletal system.” As a physician, it is my job to provide medical care and education to the public and I am happy to do so here.
Your primary care physician is specifically trained to assess not only your musculoskeletal system, but all the other systems in your body.
We undergo extensive training in anatomy and physiology for the first two years of medical school, where we learn about the “muscles, bones, cartilage, tendons, ligaments, joints and other connective tissues,” in addition to all of the other systems of the body.
We spent countless hours learning about how to perform a physical exam and, most importantly, form a differential diagnosis – a list of possible problems based on your history and physical exam.
It is of utmost importance that you see your physician for any symptoms you are experiencing. A physical therapist is not trained to diagnose other medical conditions you might be experiencing.
For example, you may be having low back pain that feels like a simple muscle strain or another benign condition such as sciatica.
However, only a physician is trained to determine if this is truly musculoskeletal or is there something more dangerous, such as an aortic dissection (a tear of the large blood vessel in your body that can kill you), a kidney stone (a very painful condition that can leave you with kidney damage), an epidural abscess (an infection inside the spinal canal that can leave you paralyzed) or any other number of serious conditions.
As physicians, we are specifically trained to assess your symptoms, determine the diagnosis and provide appropriate treatment and referrals.
I value the role our physical therapists play in treating musculoskeletal conditions. They are well trained and educated, have experience tailoring specific therapy to your condition, and spend significant time with you to help you achieve your goals.
They are an excellent resource for the treatment and rehabilitation of musculoskeletal conditions. However, it first needs to be established your symptoms are musculoskeletal and not something more serious, and you must see a physician before obtaining physical therapy.
Joshua Bucher, MD
Joshua Bucher is a practicing emergency physician at Robert Wood Johnson University Hospital and an assistant professor in the Department of Emergency Medicine at Rutgers – Robert Wood Johnson Medical School.