Do I need diagnostic tests and results before I start PT?

Ask the Professional June 13, 2008
Jane O’Brien, MSPT

Do I need to have an X-ray or MRI and get the results before I start Physical Therapy?
Diagnostic tests are always helpful when assessing a client’s dysfunction, but they are not necessary prior to starting Physical Therapy. During the initial examination, the physical therapist (PT) will take the patient’s history to assess the nature of the problem. She will perform an examination of the client consisting of inspection of the body for posture and deformity, palpation of the tissues involved checking for tension, pain and inflammation. She will look at active and passive movements of the dysfunctional area. Additional clinical tests will be performed by the PT to help determine a diagnosis. The results of this comprehensive evaluation will indicate the nature of the client’s problem and lead to the development of a treatment plan.
Diagnostic tests can be used to validate the clinical exam results. They can provide clarity to any uncertainties regarding the dysfunction that the exam could not pick up. Many times, clients begin therapy without having had diagnostic tests and find that therapy alleviates their symptoms. If the problem is corrected, there is no need to have diagnostic tests after the fact. If the problems continue, X-rays or MRI may be ordered to determine how to redirect their treatment. The common thought is not to delay the healing measures by waiting to receive tests but to start therapy early, shorten the healing time and add diagnostic tests later if needed.