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Exploring the Fascinating World of Physical Therapy: Education, Specializations, and Benefits

Learn how physical therapists are trained, which ten specialties they can certify in, and how PT helps with chronic pain and fall prevention.

By Written Facts StaffJune 3, 2023Updated October 14, 20267 min read

You bend to pick up a laundry basket, feel a sharp twinge in your lower back, and wonder whether this means painkillers, a doctor's visit, or something else. Often the answer is physical therapy. In the U.S., physical therapists are licensed, doctorally trained clinicians who manage pain and movement problems without surgery. They can earn board certification in ten specialties. Federal health guidelines recommend them as a first-line treatment for chronic pain and for preventing falls. In every state, you can see one without a physician's referral, though most states set some limits.

What Physical Therapy Is, and What It Isn't

State physical therapy practice acts, and the model act published by the Federation of State Boards of Physical Therapy (FSBPT), define physical therapy as non-surgical patient management. Physical therapists do not perform surgery, and they do not make medical diagnoses. Their work is to evaluate how you move and to treat the problems that limit it.

Within that scope, some tools are reserved for them. The American Physical Therapy Association (APTA) lists dry needling as an intervention performed exclusively by physical therapists. Most states and D.C. allow it, under state rules on training, face-to-face instruction, and who may perform it.

Other boundaries matter just as much. Evaluating and treating memory loss and cognitive-communication disorders belongs to speech-language pathologists and occupational therapists. Physical therapists address thinking-related problems through "dual-tasking," which pairs a mental task with a physical one to improve balance, movement, and safety.

Born in a War Hospital

The profession took its modern American shape during World War I. In 1917, the U.S. Army Surgeon General created the Division of Special Hospitals and Physical Reconstruction. He appointed Marguerite Sanderson and Mary McMillan to Walter Reed General Hospital to organize and train civilian "reconstruction aides," women who provided rehabilitation to wounded soldiers.

Those aides went on to build a profession. On March 24, 1921, 274 charter members met at Keens Chophouse in New York City and founded the American Women's Physical Therapeutic Association. They elected Mary McMillan as its first president. In the late 1940s, that group became the American Physical Therapy Association.

How Physical Therapists Are Educated

Today's training is far longer than the wartime aide courses. Physical therapists must graduate from a Doctor of Physical Therapy (DPT) program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE). CAPTE is the only agency recognized by the U.S. Department of Education and the Council for Higher Education Accreditation to accredit entry-level physical therapist and physical therapist assistant programs. A CAPTE-accredited degree is required before a graduate can sit for the national licensing exam.

According to APTA, DPT programs spend about 77% of instructional time on classroom and lab work. The other 23% goes to full-time clinical education, with programs typically requiring 30 to 42 weeks of clinical internships.

Physical therapist assistants (PTAs) follow a shorter path. They complete an accredited associate degree, which takes about two years, and then pass a national licensure exam to practice.

Getting and Keeping a License

The degree alone is not enough to treat patients. Graduates must pass the National Physical Therapy Examination (NPTE), which the FSBPT administers at Prometric testing centers. The computer-based exam has 225 multiple-choice questions for physical therapists and 180 for PTAs. The fee is $485.

Licenses are issued by states, which has long made it harder for therapists to work across state lines. The Physical Therapy Compact addresses this. As of October 2026, 38 jurisdictions issue and accept "compact privileges," which let eligible therapists practice in member states without a separate license in each one.

Keeping a license also depends on the state. Each state board sets its own continuing education or continuing competence requirements, including how many credits are needed and how often licenses must be renewed. No national organization sets a single standard.

Specializing After Licensure

Many therapists focus on one area of practice after they are licensed. The American Board of Physical Therapy Specialties (ABPTS) offers board certification in ten clinical areas:

Cardiovascular and Pulmonary
Clinical Electrophysiology
Geriatrics
Neurology
Oncology
Orthopaedics
Pediatrics
Pelvic and Women's Health
Sports
Wound Management

To earn certification, a therapist needs an unrestricted license and documented patient-care hours in the specialty, and must pass a written exam. Certification runs on a 10-year cycle under ABPTS's Maintenance of Specialty Certification framework.

One area is notably absent from the list: animals. Some physical therapists do rehabilitation work with animals. That work falls mainly under state veterinary practice acts, because a physical therapy license covers only human patients. APTA's position is that it requires veterinary supervision or specific authorization in state law.

What Physical Therapy Does for You

This training pays off most clearly in two areas where federal health guidance points directly to physical therapy.

The first is pain. The CDC's clinical guideline on prescribing opioids recommends physical therapy and exercise therapy as preferred first-line, non-drug treatments for chronic pain, such as low back pain and osteoarthritis. The goal is to reduce reliance on opioids and the risks that come with them.

The second is falls in older adults. Under the CDC's STEADI initiative (Stopping Elderly Accidents, Deaths & Injuries), clinicians who screen adults aged 65 and older are told to refer people with gait, strength, or balance problems to physical therapy for fall prevention.

Do You Need a Referral?

You can usually start without one. As of July 2025, all 50 states, D.C., and the U.S. Virgin Islands allow patients to see a physical therapist directly. In 21 states, that access is unrestricted. The other 29 states and the territories allow it with conditions, such as a cap on the number of visits or days of treatment before a physician must be involved. Rules vary, so check your state's rules and your insurance plan before you book.

A Growing Profession

Demand for physical therapists is rising. The U.S. Bureau of Labor Statistics counted 283,700 physical therapist jobs in 2025. It projects 12% growth from 2025 to 2035, much faster than the average for all occupations, with about 13,400 openings each year. The median annual wage was $102,760, or $49.40 an hour, in May 2025.

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