Primary Care Provider First. In this model, patients would have an initial assessment from the primary care provider, which is considered standard care. If the primary care provider deems that the patient should be referred for physical therapy for medically necessary treatment, the research coordinator will randomly assign physical therapy referral to the onsite physical therapist at the Duke Outpatient Clinic or to an offsite location. The research coordinator will assist with scheduling and track referrals and all outcome data for patients referred offsite. In some cases, the primary care provider will not refer to physical therapy. In this case, the patients will follow the care recommendations provided by the primary care provider.