Your Doctor Prescribed PT for a Work Injury: What Happens Now?

After a work injury, physical therapy starts with an evaluation, then a plan built for you and regular visits where your progress is checked. All of it is aimed at getting you back to your job safely, whether you stock shelves in a Wallingford warehouse, stand through a shift at a Milford counter, or sit at a desk in New Haven.

If your doctor just handed you a prescription for physical therapy, you probably left with questions the appointment didn't have time for, starting with what the first visit involves.

What happens at your first work-injury physical therapy visit?

The first visit is an evaluation built around you and your job. Your treating provider takes a detailed history, performs an examination, makes a diagnosis, and forms an individualized treatment plan. At Omni, that plan may include chiropractic care, physical therapy, further testing or imaging, a modified return-to-work plan, or a combination.

Expect questions that go beyond where it hurts. For low back pain, for example, a physical therapist's evaluation can include an assessment of how you use your body at work, at home, during sports, and at leisure (opens in a new tab). Before you go, think about what a normal shift asks of you: how much you lift and how often, whether you stand, kneel, or reach overhead, how long you sit, and which tasks have gotten hard since the injury.

The exam also looks for anything that needs a different kind of care. In a low back pain evaluation, a physical therapist may run tests for signs of a more serious health problem, such as a broken bone. If they suspect a more serious condition, they'll refer you to other health care specialists for further evaluation.

In 2021, an academy of the American Physical Therapy Association published a clinical practice guideline for people whose ability to work is limited after an injury or illness (opens in a new tab), with recommendations for physical therapy evaluation, treatment, and management.

Plan on about an hour for a first visit at Omni, and wear comfortable clothing you can move in.

How is work-injury physical therapy different from regular physical therapy?

Work-injury physical therapy uses the same tools as other rehab, but progress is measured against the physical tasks your job requires as well as your daily activities.

Your job matters here because injuries to muscles, nerves, tendons, joints, and spinal discs can be caused or made worse by work that involves lifting, pushing, pulling, or carrying many or irregularly shaped objects (opens in a new tab), holding awkward postures, vibration from machinery and tools, or doing a task harder, more often, or for longer. Examples (opens in a new tab) include carpal tunnel syndrome, tendinitis, rotator cuff injuries in the shoulder, epicondylitis (which affects the elbow), trigger finger, and muscle strains and low back injuries.

That's why your therapist may look closely at how you lift, bend, and sit, not only at how strong you are. For low back pain, for example, physical therapy can include training on proper lifting, bending, and sitting, including ways to do chores at work and at home.

What is work conditioning, and when does it start?

At Omni, work conditioning is the final phase of work-injury care, when exercise shifts toward the specific demands of your job. It's meant to support a safe return and reduce the risk of re-injury when you go back.

Recovery typically begins with focused treatment for pain and acute symptoms, paired with stretching, exercise programs, and other treatments to restore range of motion and mobility. Throughout your plan, Omni's physical therapists may combine heat, cold, electrical stimulation, joint mobilization, exercise, massage, aquatic therapy, and patient education, depending on your needs and goals.

What work conditioning looks like depends on the job. Someone who loads trucks may need to build up to lifting and carrying again, while someone who sits through a full shift may need more work on comfortable posture and on getting up and moving. Omni can also support a modified return-to-work schedule when appropriate. Ask your provider where you are in the plan, what needs to happen before the next phase, and whether a modified schedule makes sense for you.

What's your part between visits?

Your part is to keep your appointments, do the home exercises, and tell your providers plainly how things are going. For low back pain, a physical therapist may also help you build a safe activity program to do on your own.

Your therapist works from what you report, so give details: which movements are easier, which still hurt, and what happened when you tried the home exercises. "The lifting exercise felt manageable, but sitting through a shift didn't" tells your provider far more than "about the same." Small details are easy to forget by the time you're back on the table, so a few notes on your phone during the week help: what you did at home or at work, how your symptoms responded, and what you want to ask.

If an exercise seems to make your symptoms worse, stop doing it and talk with your doctor or physical therapist before you try it again. For the urgent symptoms listed below, get care right away instead.

If you hurt your low back, staying in bed can feel like the safe choice, but bed rest for longer than one day can slow your recovery. The usual advice is to stay active and do as much of your normal routine as possible, within any limits your doctor or therapist has set.

If recovery is slower than you hoped, tell your providers and keep coming to your visits. They may adjust the plan based on what they learn, and they can tell you which activities to keep doing in the meantime.

Which symptoms need medical care right away?

If back pain comes with any of these, go to an emergency room immediately (opens in a new tab): being unable to urinate, loss of bladder or bowel control, numbness in your groin, buttocks, or inner thighs, or numbness or weakness in your legs that is severe or getting worse. They can point to cauda equina syndrome, a surgical emergency (opens in a new tab) in which nerve roots in the lower spine are squeezed.

Call 911 right away (opens in a new tab) if you suddenly have numbness or weakness in the face, arm, or leg, especially on one side of the body, or sudden trouble walking, dizziness, or loss of balance. Those are warning signs of a stroke. Chest discomfort and shortness of breath are among the most common heart attack symptoms (opens in a new tab), so call 911 for those too, even if you aren't sure it's a heart attack.

If none of those emergency signs apply, call your doctor right away for back pain with weakness or numbness in a leg (opens in a new tab), difficulty walking or keeping your balance that didn't start suddenly, pain that travels down your leg below the knee, pain after a new fall or severe blow, or an unexplained fever.

Where does Omni provide work-injury care?

All five Omni offices treat workers' compensation injuries: East Haven, Meriden, Milford, Wallingford, and West Haven. We treat spine strains, shoulder and neck injuries, herniated discs, lower back pain, repetitive-use injuries, and job-site trauma, whether your work is physically demanding or desk-based. The Connecticut Workers' Compensation Commission administers the state's workers' compensation laws (opens in a new tab).

Physical therapy, including aquatic therapy, is based at the Wallingford office and always requires a physician's referral. If you don't have one yet, ask your physician, then call us and our staff will take care of the rest. Chiropractic care is available at all five offices (Tuesdays and Thursdays in Wallingford) and doesn't require a referral. Our chiropractic physicians can also refer you in house to our physical therapists. Our patient-centered approach connects physical therapy and chiropractic care under one roof, and the practice's medical affiliations let us refer you to pain medicine physicians and other specialists when your care calls for it. You can read more on our workers' compensation injury care page.

For your first visit, bring any referral from another provider, your work injury date, and your employer information. If your doctor has prescribed therapy for a work injury, call Omni at (203) 562-8600 to schedule an evaluation or with any questions before your first visit.