One of the common treatment options that Drs. Chimes and Hyman recommend to patients is formal Physical Therapy (PT). When writing these referrals, they will often prescribe 12 sessions.
Where does the number 12 come from? It's an arbitrary number. Different patients need different numbers of session, so 12 is a baseline number that helps for insurance approval. The actual number of visits a patient needs is more complex, and will vary from person to person. Many patients get better with a much smaller number (e.g., 4-6 sessions), while some more complicated injuries may take longer.
The purpose of this blog post is to give patients an idea of what to expect out of PT and how long they should continue with it in order to obtain optimum benefit.
- The blue portion of the graph represents the period of "high benefit" where the gains are greatest, when a patient initially starts physical therapy.
- It is important to understand that the first visit is likely to be more of an assessment and that true gains will begin accumulating in the visits that follow.
- After about 2-5 sessions you should be able to get a sense as to whether or not you are on the right track. This is the accelerated portion of PT, where the largest gains are often seen. This is represented by the blue portion of the graph above, and may represent as few as 2 sessions, but sometimes may require as many as 10-20 sessions, depending on the patient.
- Over time, as you attend more sessions, you may experience less benefit from each session. It is still very important that you continue with the therapy as these smaller gains help with "preventing injury recurrences", represented by the red portion of the graph.
- At this point, it may be appropriate for you to increase the amount of time between appointments. This will allow you to develop a "home maintenance program" while still periodically checking in with your PT to make sure home program is properly optimized.
- However, eventually you will reach a point when you will begin to get "limiting returns" from your physical therapy sessions. This is a time when you have developed a sufficient base to return to activity while minimizing the risk of re-injury. This is represented by the green portion of the graph.
- In regards to the question of how long you should attend physical therapy, ideally the sweet spot would be between red and green portions of graph, where you have learned how to prevent recurrences but have not reached a point of diminishing returns.
- There isn't a magic number of visit that corresponds to this sweet spot. When you feel as though you may be approaching this point, discuss this with your physical therapist and/or physician and talk about transitioning to a home exercise program.
- A physical therapy program is only as good as the effort a patient puts into it. The bread and butter of any PT program is the home exercise program. Patients who are fully participatory in their home program get better more quickly. Listen to your PT!
