Why 6 in 10 People Who Need PT Never Get Referred

Oct 6

2 min read

Ask someone with Parkinson's disease or MS whether they've been to physical therapy, and a lot of them will say the same thing: nobody told them they should. Not because PT doesn't help. The evidence for that is about as strong as evidence gets in neuro-rehab. It's because referral itself is inconsistent, delayed, or skipped altogether, and most people have no way of knowing that.

A retrospective study covering more than 9,700 people newly diagnosed with Parkinson's disease found that only 36.9% received physical or occupational therapy within two years of diagnosis (Longhurst et al., 2024, Journal of Parkinson's Disease). Guidelines call for referral at diagnosis, immediately, not eventually.

It gets more specific. A recent audit at a movement disorders clinic found that 83% of patients were assessed as actually needing physical therapy. Only 39% were referred (Cunningham et al., 2026, Disability and Rehabilitation). The people they interviewed named three real barriers:

Not knowing PT could help,
Assuming it was too hard to access
Assuming they couldn't afford it.

And referral rates aren't consistent even across specialized centers. A review of PT practices found referral rates ranging from 13% to 71% depending on which clinic a person happened to be seen at, with most people only getting referred after they'd already fallen (LeLaurin et al., 2023, JAMA Network Open). Whether you get access to PT winds up depending less on what you need and more on which door you walked through.

We want to be direct about what this means. If nobody has mentioned physical therapy to you, that's not a sign you don't need it. It might just mean you haven't been given the map yet. And you don't need a referral, a diagnosis code, or a doctor's note to start with us. In a cash-based practice, you get to decide when you're ready, not a referral system that only catches 4 in 10 people who need it.

If you've been waiting for someone to bring this up, consider this us bringing it up. Book a free consultation and we'll figure out what your specific situation actually needs.

A quick note: this post is educational, not individualized medical advice, and it's not a substitute for an evaluation with a licensed physical therapist or your own physician. Everyone's situation with Parkinson's disease or MS is different, and what's safe and effective for one person may not be for another. If you want to talk through your specific situation, we'd love to hear from you. Book a free consultation