In Quebec, a doctor’s referral is not necessary to start physiotherapy. In fact, most of our clients who did physiotherapy in the past come directly to see us. As long as there are no open wounds, possibility of a fracture or damage to the major organs, it is generally safe to start physiotherapy before seeing a doctor.
Medical doctors are, however, great sources for prescription of medications to medically manage pain or inflammation and to overlook drug interactions if a client has multiple medical conditions. Better control of pain & inflammation can help physiotherapists focus more on the mechanical problems.
Furthermore, referral to an orthopedic surgeon may be necessary if the orthopedic condition is beyond repairable with just physiotherapy along. With the advances made in the medical field, there are now many surgeries that are a lot safer and have more success rates than in the past.