Physiotherapist or Orthopaedic Doctor: Who Should You See First?

Your knee has been aching for three weeks. Should you see an orthopaedic doctor or a physiotherapist? Most people start by guessing. You can do better by knowing what each one actually does.

What an orthopaedic doctor does

An orthopaedic surgeon is a medical doctor who diagnoses bone, joint and muscle problems, orders scans and blood tests, prescribes medicines, gives injections and performs surgery. If something is broken, badly torn, infected or needs an operation, they are the right person.

What a physiotherapist does

A physiotherapist assesses how your body moves, finds what is overloaded or weak, and treats it with hands-on therapy, exercise, posture and load advice, and pain-relief techniques. Physiotherapy is the main treatment for most everyday aches, sprains and strains, and the main way people recover after orthopaedic surgery.

See a doctor first if you have:

• A fall, accident or sports collision followed by severe pain, swelling or deformity, or you can't put weight on the limb
• Pain with fever, unexplained weight loss, or a history of cancer
• A hot, red, swollen joint
• Numbness, weakness or loss of bladder or bowel control
• Pain that keeps you awake every night no matter what position you are in

These can be signs of a fracture, infection or nerve compression. They need medical assessment and sometimes a scan before anything else.

A physiotherapist is a sensible first step if:

• Pain came on gradually, or after an awkward movement, lifting or a new activity
• It changes with position or activity, for example worse after sitting and better after a walk
• You feel stiff, weak or unsteady rather than seriously injured
• It's a recurring problem, like back pain that flares every few months

A good physiotherapist will screen for the warning signs above during the first assessment. If anything suggests you need a doctor, a scan or a specialist, they will refer you.

Often the answer is both

Doctors and physiotherapists work best together. A doctor might confirm a ligament tear, then send you for physiotherapy to rebuild strength. A physiotherapist might notice weakness that needs a nerve test and refer you back. After joint replacement or fracture fixation, the surgery is only half the job; the rehabilitation decides how well the joint works afterwards.

Bottom line

Serious injury or warning signs: doctor first. Gradual, movement-related pain: physiotherapy first is usually reasonable, and you'll be referred on if needed. If you're not sure which group you're in, call or message us and we'll help you decide.